scholarly journals A Window in the Heart Is Sometimes a Good Start: It’s Not Always Sepsis

2021 ◽  
Author(s):  
Subrat Khanal ◽  
◽  
Hassan Al-Khalisy ◽  
Keyword(s):  
Cardiac Tamponade ◽  
Clinical Diagnosis ◽  
Pericardial Fluid ◽  
Transmural Pressure ◽  
Critical Levels ◽  
Fluid Accumulation ◽  
Compensatory Mechanisms ◽  
Hemodynamic Compromise ◽  
Abnormal Accumulation ◽  
Life Threatening

Cardiac tamponade is a life-threatening compression of the heart caused by abnormal accumulation of pericardial fluid. Important elements affecting its disposition and treatment are the rate of fluid accumulation relative to pericardial stretch and the effectiveness of compensatory mechanisms before critical hemodynamic compromise occurs. It is a clinical diagnosis and waiting for the threshold of steep rise in cardiac transmural pressure to critical levels may lead to catastrophic outcomes which is why early drainage has to be strongly considered in suspected cases.

scholarly journals A Novel Ultrasound-guided With Needle Visualization Pericardiocentesis Via Subcostal Approach

2021 ◽  
Author(s):  
Osman Adi ◽  
Nurul Shaliza Shamsudin ◽  
Chan Pei Fong ◽  
Muhammad Faiz Baherin ◽  
Azma Haryaty Ahmad
Keyword(s):  
Cardiac Tamponade ◽  
High Frequency ◽  
Technology Development ◽  
Surgical Techniques ◽  
Pericardial Fluid ◽  
Ultrasound Guided ◽  
Hemodynamic Status ◽  
Hemodynamic Compromise ◽  
Plane Technique ◽  
Needle Trajectory

Abstract Cardiac tamponade is a condition when fluids or blood fill the pericardial space resulting in compression of the heart and subsequently compromising hemodynamic status of the patient. It is a potentially fatal medical or traumatic emergency that requires rapid recognition and immediate treatment. Formerly, blind or surgical techniques were used to aspirate the pericardial fluid and they were associated with plenty of risks and complications. In the recent era, medical technology development has enabled us to perform the procedure safely with the assistance of ultrasound devices. The ultrasound-guided procedure is not only proven to be effective and safe, but it also has very minimal drawbacks and complications. In the literature, there are many ultrasound-guided pericardiocentesis procedures performed with different approaches at different regions. They include subcostal, parasternal, and para-apical approaches and phased array echocardiography transducers are typically preferred for the procedures. We report a case of cardiac tamponade presented with hemodynamic compromise. Ultrasound-guided pericardiocentesis was carried out using in-plane technique with high frequency linear ultrasound transducer at the subcostal region as lifesaving procedure. This particular technique provided full visualization of needle trajectory throughout the procedure. It was successfully completed with no complications and patient’s hemodynamic status improved post-procedure. This article highlights the novel use of in-plane method with high frequency linear transducer at subcostal area as a safe option for pericardiocentesis in patients with cardiac tamponade.

scholarly journals A case of tuberculosis pericarditis with an interesting echocardiographic image

2018 ◽  
Author(s):  
Kursat Arslan ◽  
Ufuk Taner ◽  
Suleyman Cagan Efe ◽  
Burak Ayca ◽  
Turgut Karabag
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Constrictive Pericarditis ◽  
Extrapulmonary Tuberculosis ◽  
Pericardial Fluid ◽  
Fluid Accumulation ◽  
Echocardiographic Image ◽  
Rare Manifestation ◽  
Echocardiographic Images

Tuberculosis-associated pericardial disorders are an excessively rare manifestation of extrapulmonary tuberculosis. The patients may present with constrictive pericarditis or pericardial fluid accumulation leading to cardiac tamponade. This paper reports a case of tuberculosis-associated pericardial effusion with dense fibrinous material not causing tamponade in a foreigner presenting with nonspecific symptoms. It also provides a discussion about the diagnostic and therapeutic methods as well as interesting echocardiographic images of the patient.

Cardiac Tamponade

2019 ◽  
pp. 66-75
Author(s):  
Todd Novak ◽  
Silas Hoxie
Keyword(s):  
Cardiac Tamponade ◽  
Early Recognition ◽  
Hemodynamic Instability ◽  
Pericardial Fluid ◽  
Anesthetic Techniques ◽  
Physiological Changes ◽  
Threatening Condition ◽  
Life Threatening ◽  
Cardiac Filling

Cardiac tamponade is a life-threatening condition that occurs when accumulating pericardial fluid results in impaired cardiac filling and hemodynamic instability. Most of the clinical features of tamponade are subtle and nonspecific and may not be appreciated until cardiovascular collapse is imminent. Understanding the physiological changes that occur during tamponade are essential for early recognition and intervention. While cardiac tamponade is a clinical diagnosis, echocardiography is the modality of choice in facilitating the prompt identification of extraneous pericardial contents and the determination of the hemodynamic significance. This chapter discusses the presentation, pathophysiology, and echocardiographic signs of tamponade, as well the differential diagnosis and confounding conditions most pertinent to the anesthesiologist. Both medical and surgical management are also addressed, including a review of perioperative and anesthetic techniques.

scholarly journals A rare case of cardiac tamponade due to tuberculosis

2017 ◽  
Vol 4 (1) ◽  
pp. 296 ◽  
Author(s):  
Deependra K. Rai ◽  
Abhishek Kumar
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Heart Function ◽  
Pericardial Tamponade ◽  
Acute Onset ◽  
Pericardial Fluid ◽  
Oral Steroid ◽  
Structural Abnormality ◽  
Pericardial Cavity ◽  
Abnormal Accumulation

Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity. Tuberculosis involvement of the pericardium is well-known and can result in pericardial tamponade apart from other sequelae like constrictive pericarditis. Here we report a case of 60 years old female of pleuropericardial effusion presented with acute onset breathlessness, palpitation, tachypnea. Urgent echocardiography shows cardiac tamponade. Pericardiocentesis was performed immediately and more than one litre hemorrhagic fluid drained. Patient was put on anti-tubercular treatment with oral steroid after adenosine deaminase positivity in exudative pericardial fluid. Patient is doing well in follw-up visit.

Pericardiocentesis

2015 ◽  
Author(s):  
Gerard Martí Aguasca ◽  
Bruno Garcia del Blanco ◽  
Jaume Sagristà Sauleda
Keyword(s):  
Cardiac Tamponade ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Procedure ◽  
Pericardial Fluid ◽  
Threatening Condition ◽  
Life Threatening ◽  
Optimal Imaging

Cardiac tamponade is a life-threatening condition that may require the urgent removal of pericardial fluid. Therefore, the pericardiocentesis procedure should be part of the skills of physicians treating critically ill patients. The pericardiocentesis technique has evolved from a blind and unguided procedure, prone to complications, to a safer and more effective guided technique by using echocardiography or fluoroscopy. However, as in any invasive procedure, complications still occur. Therefore, indications should be restricted to patients with cardiac tamponade or a high suspicion of specific aetiologies when performed for diagnostic purposes. Accurate indications, optimal imaging assessment, knowledge of materials required, familiarization with different techniques, and rapid recognition of complications are key for a successful procedure.

scholarly journals AspergillusPericarditis with Tamponade in a Renal Transplant Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Sylvia Biso ◽  
Rapeepat Lekkham ◽  
Antoinette Climaco
Keyword(s):  
Renal Transplant ◽  
Cardiac Tamponade ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Clinical Manifestations ◽  
Pericardial Fluid ◽  
Immunosuppressed Patients ◽  
Life Threatening ◽  
Disease Entities ◽  
High Degree

Aspergilluspericarditis is a rare and life-threatening infection in immunosuppressed patients. It has nonspecific clinical manifestations that often mimic other disease entities especially in patients who have extensive comorbidities. Diagnosis is oftentimes delayed and rarely done antemortem. A high degree of suspicion in immunocompromised patients is necessary for evaluation and timely diagnosis. This is a case ofAspergilluspericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis. Two months after transplant, he developed decompensation of his cirrhosis from hepatitis C, acute cellular rejection, andKluyverabacteremia, followed by vancomycin-resistantEnterococcus faecium(VRE) bacteremia. Four months after transplant, the patient presented with lethargy and fluid overload. He subsequently developed shock and ventilator-dependent respiratory failure. An echocardiogram showed pericardial effusion with cardiac tamponade. He had emergent pericardiocentesis that showed purulent drainage. He was started on broad-spectrum antibiotics. Amphotericin B was initiated when the pericardial fluid grew mold that was later identified asAspergillus fumigatus. The patient quickly decompensated and expired.

scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Lardinois Benjamin ◽  
Goeminne Jean-Charles ◽  
Miller Laurence ◽  
Randazzo Adrien ◽  
Laurent Terry ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Cardiac Toxicity ◽  
Checkpoint Inhibitors ◽  
Final Diagnosis ◽  
Pericardial Fluid ◽  
Malignant Pericardial Effusion ◽  
Typical Cell ◽  
High Fluorescence ◽  
Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

scholarly journals Management of Cardiac Tamponade: A Comperative Study between Echo-Guided Pericardiocentesis and Surgery—A Report of 100 Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Hasan Ali Gumrukcuoglu ◽  
Dolunay Odabasi ◽  
Serkan Akdag ◽  
Hasan Ekim
Keyword(s):  
Surgical Treatment ◽  
Cardiac Tamponade ◽  
Total Mortality ◽  
Invasive Procedure ◽  
Mortality Rates ◽  
Pericardial Fluid ◽  
Complication Rates ◽  
Optimal Method ◽  
First Choice ◽  
Group A

Background. Cardiac tamponade (CT) represents a life-threatening condition, and the optimal method of draining accumulated pericardial fluid remains controversial. We have reviewed 100 patients with CT at our institution over a five-year period and compared the results of echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis with regard to functional outcomes.Methods. The study group consisted of 100 patients with CT attending Yuzuncu Yil University from January 2005 to January 2010 who underwent one of the 3 treatment options (echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis). CT was defined by clinical and echocardiographic criteria. Data on medical history, characteristics of the pericardial fluid, treatment strategy, and follow-up data were collected.Results. Echo-guided pericardiocentesis was performed in 38 (38%) patients (Group A), primary surgical treatment was preformed in 36 (36%) patients (Group B), and surgical treatment following pericardiocentesis was performed in 26 (26%) patients (Group C). Idiopathic and malignant diseases were primary cause of tamponade (28% and 28%, resp.), followed by tuberculosis (14%). Total complication rates, 30-day mortality, and total mortality rates were highest in Group C. Recurrence of tamponade before 90 days was highest in Group A.Conclusions. According to our results, minimal invasive procedure echo-guided pericardiocentesis should be the first choice because of lower complication and mortality rates especially in idiopathic cases and in patients with hemodynamic instability. Surgical approach might be performed for traumatic cases, purulent, recurrent, or malign effusions with higher complication and mortality rates.

Sign in / Sign up

Export Citation Format

Share Document