The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

scholarly journals Cardiac tamponade due to malignant pericardial effusion in breast cancer: A case report

2016 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Sultan Mahmud ◽  
Omar Sadeque Khan ◽  
Md. Aftabuddin ◽  
Asit Baran Adhikary
Keyword(s):  
Breast Cancer ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Duct Cell ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Severe Respiratory Distress ◽  
Malignant Pericardial Effusion ◽  
History Of ◽  
Subxiphoid Pericardial Window

We present a case of 35 years old women who presented to our institution with a history of bilateral infiltrating duct cell carcinoma of breast, chest pain with heaviness, severe respiratory distress and hypotension. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. The patient was treated with urgent pericardiocentesis followed by subxiphoid pericardial window drainage of 500ml of haemorrhagic pericardial fluid. Cytological examina­tion confirmed the previous suspicious of malignancy. The patient tolerated the procedure very well, immediate sympto­matic relief was observed.

scholarly journals Pericardial Tamponade And Lung Adenocarcinoma: Case Report And Literature Review

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Irene Lozano-Díez ◽  
María López-Rodríguez ◽  
Laia Cagide-González ◽  
José Antonio Díaz-Peromingo
Keyword(s):  
Pericardial Effusion ◽  
Lung Adenocarcinoma ◽  
Previous History ◽  
Pericardial Tamponade ◽  
Neoplastic Disease ◽  
Healthy Patient ◽  
Lung Cancers ◽  
Life Threatening ◽  
History Of ◽  
Recurrent Pericardial Effusion

Pericardial effusion is the accumulation of fluid between the layers of the pericardium. I massive, pericardial tamponade and compression of the myocardium are life threatening conditions. The causes of pericardial effusion are varied, from idiopathic, neoplasms, iatrogenesis, and autoimmune. Pericardial tamponade can be a complication of neoplastic disease. Malignancy must be ruled out in every cardiac tamponade. Malignant etiology must be considered in patients with previous history of malignancy, pericarditis that does not respond to anti-inflammatory treatment, pericardial effusion that increases its amount rapidly, or recurrent pericardial effusion. Metastatic pericardial effusion due to lung cancer is not rare but not all lung cancers involve the same way the pericardium. In this paper, we present the case of a previously healthy patient with pericardial tamponade as presentation form of a lung adenocarcinoma and review the literature.

scholarly journals ХИРУРГИЯ ЭКССУДАТИВНЫХ ПЕРИКАРДИТОВ

2019 ◽  
pp. 14-19
Author(s):  
Лигоненко А. В.
Keyword(s):  
Pericardial Effusion ◽  
Diagnostic Methods ◽  
Common Disease ◽  
Clinical Progression ◽  
Surgical Interventions ◽  
Pericardial Cavity ◽  
Differential Approach ◽  
Literary Sources ◽  
Choice Of Treatment

In the article are presented modern approaches to diagnostics, etiological search and methods of surgical correction of pericardial effusion (PE) of different etiology. PE being the most common disease of the pericardium, often has a secondary nature. The overview of modern literature data is presented about terminology and classification of PE, the possibility of etiological search for the cause of effusion in the pericardial cavity, the main diagnostic methods, as well as the main tasks and methods of pericardial surgical interventions and its indications. Based on the analysis of literary sources, we can conclude that the consensus on the clinical and nosological structure, effectiveness and necessity of using various tests and interventions, clinical progression, epidemiology, prognosis and the reasons for the unsatisfactory results of treated PE is actually absent. Our analysis indicates the absence of a systematic and differential approach to choice of treatment tactics.

scholarly journals 1095 Effective image-guided medical management in effusive constrictive pericarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Montes ◽  
A Cecconi ◽  
T Alvarado ◽  
A Vera ◽  
A Barrios ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Medical Treatment ◽  
Constrictive Pericarditis ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Intravenous Corticosteroid ◽  
Persistent Inflammation ◽  
High Doses ◽  
Effusive Constrictive Pericarditis

Abstract A 59 year old man was admited to hospitalization for persistent chest pain related to acute pericarditis. Within the admision tests, a transthoracic echography was performed, showing a moderate pericardial effusion with ventricular septal bounce and significant respiratory variations in mitral and tricuspid inflows, all of it consistent with effusive-constrictive pericarditis (Panel A). Anti-inflammatory treatment with ibuprofen and colchicine was started. During the first 48 hours of admission there was a clinical and hemodinamic worsening in the patient’s condition that forced the performance of a pericardial window, obtaining a very little quantity of dense pericardial fluid. Looking for a more accurate study of the pericardium, a cardiovascular magnetic resonance (CMR) was performed, revealing a thick heterogeneous pericardial effusion (Panel B) and a significant late gadolinium enhancement of both pericardial layers (Panel C). All these findings where consistent with an effusive constrictive pericarditis with persistent inflammatory activity despite high doses of conventional inflammatory treatment. Furthermore, the growth of Propionibacterium acnes in the pericardial fluid disclosed the etiology of this condition. Medical treatment was enhanced with high doses of intravenous corticosteroid, ceftriaxone and doxycycline. During the following days, the patient showed an excellent response achieving the complete clinical and echocardiographic relief of constrictive signs (Panel D). Effusive constrictive pericarditis is characterized by the presence of pericardial effusion and constriction secondary to an inflammatory process of the pericardium. Pericardiectomy might be necessary in case of failure of medical treatment, a very common scenario in this kind of .pericarditis. Our case is remarkable because it demonstrates the value of CMR to detect persistent inflammation of pericardium despite high doses of conventional medical treatment for pericaricarditis guiding the successful escalation to intravenous corticosteroid and avoiding the risk of an unnecessary cardiac surgery. Abstract 1095 Figure.

scholarly journals Hydralazine Induced Lupus Syndrome Presenting with Recurrent Pericardial Effusion and a Negative Antinuclear Antibody

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Praneet Iyer ◽  
Ahmed Dirweesh ◽  
Ritika Zijoo
Keyword(s):  
Pericardial Effusion ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Autoimmune Disorder ◽  
Unique Case ◽  
Drug Induced ◽  
Pericardial Window ◽  
Lupus Syndrome ◽  
Chronic Use ◽  
Recurrent Pericardial Effusion

Drug induced lupus erythematosus (DIL or DILE) is an autoimmune disorder caused by chronic use of certain drugs. We report a unique case of hydralazine induced lupus syndrome (HILS) with a negative antinuclear antibody in a female patient who was on hydralazine for a period of 1.5–2 years and developed recurrent pericardial effusion as a result of it. Initially her condition was managed with a pericardial window. The recurrence of a massive pericardial effusion necessitated a right hemipericardiectomy. After hydralazine was stopped, she never had any further episodes of pericardial effusion or tamponade.

scholarly journals Intracerebral Bleeding and Massive Pericardial Effusion as Presenting Symptoms of Myxedema Crisis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
M. Kirsch ◽  
C. Rimpau ◽  
C. H. Nickel ◽  
P. Baier
Keyword(s):  
Pericardial Effusion ◽  
Neurological Impairment ◽  
Pericardial Tamponade ◽  
Intracerebral Bleeding ◽  
Presenting Symptoms ◽  
Adverse Health Outcomes ◽  
Life Threatening ◽  
History Of ◽  
Tremendous Importance ◽  
Work Up

The endocrinological emergency of a fully blown myxedema crisis can present as a multicolored clinical picture. This can obscure the underlying pathology and easily lead to mistakes in clinical diagnosis, work-up, and treatment. We present a case of an unconscious 39-year-old patient with a medical history of weakness, lethargy, and findings of hyponatremia, intracerebral bleeding, and massive pericardial effusion. Finally, myxedema crisis was diagnosed as underlying cause. Replacement therapy of thyroid hormone and conservative management of the intracerebral bleeding resulted in patient’s survival without significant neurological impairment. However, diagnostic pericardiocentesis resulted in life-threatening pericardial tamponade. It is of tremendous importance to diagnose myxoedema crisis early to avoid adverse health outcomes.

scholarly journals Subacute idiopathic pericarditis with a large pericardial effusion in a young adult seven months post COVID-19 (SARS-Cov-2) infection

2021 ◽  
Vol 10 (1) ◽  
pp. 340-342
Author(s):  
Ashan T Hatharasinghe ◽  
Andrey E Manov
Keyword(s):  
Pericardial Effusion ◽  
Time Frame ◽  
Young Female ◽  
Past Medical History ◽  
Active Infection ◽  
Pericardial Window ◽  
Large Pericardial Effusion ◽  
The World ◽  
History Of ◽  
Short Time

The number of COVID-19 (SARS-Cov-2) cases has risen substantially throughout the world, and consequently we are finding there are several extrapulmonary manifestations associated with this disease. Viral pericarditis and pericardial effusion have been reported several times in COVID-19 patients, however the majority of these cases occurred during active infection or within a relatively short time frame afterwards. The following case is a young female with only a past medical history of COVID-19 pneumonia, seven months prior, presenting with abdominal pain and progressively worsening dyspnea. She was subsequently found to have a large pericardial effusion without tamponade, but requiring a pericardial window. Gross pathology showed fibrinous pericarditis. It is suspected her symptoms and pericardial effusion resulted from a subacute idiopathic pericarditis likely as post-viral complication of COVID-19.

scholarly journals Subxiphoid window drainage of pericardial effusion - study of 35 cases

1970 ◽  
Vol 5 (2) ◽  
pp. 71-74 ◽  
Author(s):  
Rezwanul Hoque ◽  
Mostafa Nuruzzaman ◽  
Sabrina Sharmin Husain ◽  
Zerzina Rahman
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Exclusion Criteria ◽  
Pericardial Window ◽  
Echocardiographic Finding ◽  
Malignant Pericardial Effusion ◽  
Physical Findings ◽  
Age Range ◽  
Effusive Constrictive Pericarditis ◽  
Video Assisted Thoracoscopic Surgery

Pericardial effusion defines the presence of an abnormal amount and/or character of fluid in the pericardial space. It can be acute or chronic and caused by a variety of local and systemic disorders, or it may be idiopathic. Pericardial effusion can be relieved by medical treatment, pericardiocentesis through a needle with or without echocardiographic guidance, or by surgical procedures, such as subxiphoid pericardial tube drainage, by creating a pericardial window through a left anterior thoracotomy, or by video assisted thoracoscopic surgery (VATS) Subxiphoid pericardial window drainages were done on 35 patients with symptomatic pericardial effusion in the Department of cardiac surgery, BSMMU, from February, 1995 through July, 2009, and were all included in this retrospective observational study. The inclusion criteria were an established diagnosis of pericardial effusion confirmed by history, physical findings and transthoracic echocardiography, hemodynamic alteration as evidenced by hypotension( systolic blood pressure < 90 mm of Hg), shortness of breath, echocardiographic finding of > 10 mm echo free space with/ without compression of heart, recurrence after pericardiocentesis, haemorrhagic or thick pericardial effusion and malignant pericardial effusion. The exclusion criteria were loculated or post surgical pericardial effusion, effusive constrictive pericarditis or where formal thoracotomy was applied for drainage of effusion. Patients were followed up at one month and three months following the drainage procedure. The age range was from 13 years to 70 years (Mean 47.86 ± SD 15.20 years), 19 (54.28%) were male, 16(45.72%) were female. The symptomatology varied but cardiac and respiratory decompression overwhelmed other symptoms. In this study tuberculosis is the most common cause of pericardial effusion, idiopathic and malignancies are other important causes. Subxiphoid window drainage is an effective process in relieving pericardial effusion and the reaccumulation rate is low. Key words: Subxiphoid window drainage; Surgical drainage of pericardial effusion; Pericardial effusion. DOI: 10.3329/uhj.v5i2.4558 University Heart Journal Vol.5(2) July 2009 pp.71-74

scholarly journals P1340 Clinical report: alert to iatrogenia

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
B Redondo Bermejo ◽  
M M De La Torre Carpente ◽  
M C Alonso Rodriguez ◽  
C Tapia Ballesteros ◽  
J C Munoz San Jose ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Injury ◽  
Invasive Procedure ◽  
Pericardial Tamponade ◽  
Percutaneous Closure ◽  
Surgical Removal ◽  
Unusual Complication ◽  
Clinical Report ◽  
Pericardial Window ◽  
Left Pleural Effusion

Abstract Background Leftatrial appendageclosure is an alternative to systemic anticoagulation for stroke prevention in appropriate atrial fibrillation patients,however, it is not without complications. Most complications arise during the procedure and in the following days, however they can also be extended over time and therefore, we must be alert. Case summary We present the clinical case of a 68-year-old man admitted to our hospital three weeks after being discharged due to a percutaneous closure of the left appendage complicated with a pericardial tamponade resolved mediated pericadiocentesis with pericarditis clinic with persistent severe pericardial effusion. After a week without being able to remove the drainage tube, he required pericardiotomy due to superinfection with adequate subsequent evolution. In the following weeks he presented a recurrent left pleural effusion that required several evacuating thoracocentesis. After last thoracocentesis, he presented a cardiac perforation showing the catheter lodged in the pulmonary artery in the chest Computed Tomography, so he was again submitted to cardiac surgery for catheter extraction. Finally after stabilization, the patient could be discharged and after 6 months of follow-up he is stable and without new complications. Discussion Post-cardiac injury syndromes is a group of inflammatory pericardial syndromes including post-myocardial infarction pericarditis, post-pericardiotomy syndrome and post-traumatic pericarditis iatrogenic or not, that’s include pericarditis after invasive cardiac interventions. It is presumed that these syndromes have an autoimmune pathogenesis triggered by an initial damage and after a latent period of a few weeks are revealed. Our patient evidence of pericardial effusion with elevated CRP several weeks after a cardiac injury due to perforated during a percutaneous closure of the left appendage complicated with a pericardial tamponade resolved mediated pericadiocentesis. The persistent effusion motivated he imposibility of removed pericadiocentesis tube, and it superinfecction required an urgent pericardiotomy. After pericardial window, the effusion continued into the left pleural. The perforation of cardiac cavities after an evacuatorythoracocentesis is a described but unusual complication that requires surgical removal. Our patient survived a pericardiocentesis, several evacuatorythoracocentesis and two cardiac surgeries, all after a percutaneous closure of the left appendage. Conclusion Any invasive procedure presents a risk of iatrogenic complication, especially in elderly patients with comorbidities. We must be alert and start a treatment as soon as possible to solve the problem. Abstract P1340 Figure. Chest-CT_EECHO2019

Sign in / Sign up

Export Citation Format

Share Document