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Pericardial effusions

A Ancion, S Robinet, P Lancellotti
Cardiac tamponade is a vital emergency. It occurs when the accumulation of intra-pericardial fluid exceeds the pericardial adaptation capacity. Pericardial pressure is equalized with that of cardiac cavities and severe heart failure occurs, most often rapidly. Several clinical presentations are possible. The diagnosis is based on the assessment of pericardial effusion and its impact on the heart by echocardiography. Supportive treatments have limited effectiveness. The only emergency treatment is drainage of the pericardium by direct puncture or by surgical approach...
May 2018: Revue Médicale de Liège
Yao Liu, Gai-Li Guo, Bin Wen, Shouzheng Wang, Wen-Bin Ou-Yang, Yongquan Xie, Xiang-Bin Pan
OBJECTIVE: Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice in patients with isolated mitral stenosis. This study aimed to assess the feasibility of PBMV under echocardiography guidance only of isolated mitral stenosis (MS). METHODS: From October 2016 to Dec 2017, 20 consecutive patients with severe MS underwent PBMV with echocardiography as the only imaging modality at a single center. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography was conducted at 1, 3,6, and 12 months after the procedure...
June 19, 2018: Echocardiography
Saurabh Arora, Averilicia Passah, Nishikant A Damle, Rajiv Narang, Atul Sharma, Madhav P Yadav, Sanjana Ballal, Dinkar Bhasin, Chandrasekhar Bal
We present the case of a 35-year-old woman with metastatic neuroendocrine tumor undergoing treatment with long-acting octreotide and Lu-DOTATATE therapy. We present features of carcinoid heart disease on Ga-DOTANOC PET/CT, which revealed dilated right atrium, pericardial effusion, ascites, and congestive hepatopathy apart from the metastatic lesions in the liver. The scan cardiac findings were confirmed by echocardiography. This highlights the significance of identifying such patients early because additional management is required for carcinoid heart disease per se and a cautious approach is needed in administering amino acid infusion during PRRT that can result in fluid overload...
June 19, 2018: Clinical Nuclear Medicine
Massimo Imazio, Antonio Brucato, Giuseppe Di Tano, Stefano Urbinati, Michele Massimo Gulizia, Domenico Gabrielli, Andrea Di Lenarda
Acute pericarditis is not uncommon in clinical practice and may occur either as isolated disease or as a manifestation of another disease (known or still unknown). The etiology is varied and complex and a clinically-oriented approach to management is possible by identifying initial presentation features of high risk (risk of complications or specific disease: fever >38°C, subacute course without acute chest pain, large pericardial effusion, cardiac tamponade, and lack of response to empiric anti-inflammatory therapy), that suggest admission and additional diagnostic evaluation...
April 2018: Giornale Italiano di Cardiologia
Massimo Imazio, George Lazaros, Antonio Brucato
Although a new or worsening pericardial effusion is a diagnostic criterion for pericarditis, in clinical practice the presence of pericardial effusion does not necessarily imply the evidence of pericarditis. Up to 40-50% of cases of pericarditis do not show the presence of pericardial effusion (dry pericarditis). The clinician should first evaluate any related symptoms and signs (symptomatic vs asymptomatic), its size and hemodynamic impact, then rule out pericarditis and the presence of an underlying disease (e...
June 2018: Giornale Italiano di Cardiologia
Alessandro Tomelleri, Giulio Cavalli, Giacomo De Luca, Corrado Campochiaro, Teresa D'Aliberti, Moreno Tresoldi, Lorenzo Dagna
Pericarditis is an inflammatory heart disease, which may be idiopathic or secondary to autoimmune or auto-inflammatory diseases and often leads to severe or life-threatening complications. Colchicine and non-steroidal anti-inflammatory drugs represent the mainstay of treatment, whereas use of corticosteroids is associated with recurrence of disease flares. While effective and safe anti-inflammatory therapies remain an unmet clinical need, emerging clinical and experimental evidence points at a promising role of inhibition of the pro-inflammatory cytokine interleukin-1 (IL-1)...
2018: Frontiers in Immunology
Sukesh Manthri, Sindhura Bandaru, Abdisamad Ibrahim, Chaitanya K Mamillapalli
Acute pericarditis as a presenting sign of adrenal insufficiency is rarely reported. We present a rare case that highlights pericarditis as a clinical presentation of secondary adrenal insufficiency later complicated by cardiac tamponade. A 44-year-old lady who presented to the hospital with a one-day history of pleuritic chest pain and shortness of breath. In the emergency room, she had a blood pressure of 70/35 mmHg. Laboratory evaluation revealed white blood cell count of 16.08 k/cumm with neutrophilia, normal renal function and elevated troponin (0...
April 13, 2018: Curēus
Suresh Giritharan, Kareem Salhiyyah, Geoffrey M Tsang, Sunil K Ohri
BACKGROUD: To assess the feasibility and efficacy of PuraStat®, a novel haemostatic agent, in achieving suture line haemostasis in a wide range of cardiac surgical procedures and surgery of the thoracic aorta. METHODS: A prospective, non-randomised study was conducted at our institution. Operative data on fifty consecutive patients undergoing cardiac surgery where PuraStat® was utilised in cases of intraoperative suture line bleeding was prospectively collected...
June 15, 2018: Journal of Cardiothoracic Surgery
Katarzyna Paździor-Czapula, Iwona Otrocka-Domagała, Patrycja Myrdek, Mateusz Mikiewicz, Michał Gesek
Dirofilaria repens is an endemic, zoonotic parasite of carnivores, causing subcutaneous dirofilariasis, which is mostly asymptomatic. The aim of this study was to describe 22 cases of canine subcutaneous dirofilariasis. The cytologic and histopathologic samples were collected from dogs, which presented with various clinical signs such as cutaneous/subcutaneous nodules, hydropericardium, ascites, and lymphadenomegaly. The cytologic or histopathologic examination revealed purulent, pyogranulomatous, granulomatous or eosinophilic dermatitis/panniculitis, and the presence of D repens microfilariae or adults...
June 2018: Veterinary Clinical Pathology
Nico Reinsch, Ute Ruprecht, Jochen Buchholz, Christoph Edel, Hagen Kälsch, Kars Neven
AIMS: Stroke due to atrial fibrillation has been associated with a high risk of disability and mortality. Percutaneous left atrial appendage (LAA) closure has been established as an alternative strategy for stroke prevention in patients not eligible for oral anticoagulation. The LAmbre is a novel occluder, specifically designed for LAA closure adaptive to various LAA anatomies. The aim of this study was to demonstrate feasibility and initial experience in a nonprescreened patient cohort for LAA occlusion using the novel LAmbre occluder...
June 11, 2018: Journal of Cardiovascular Medicine
Manesh Kumar Gangwani, Salman B Mahmood, Fariha Hasan, Javaid A Khan
Constrictive pericarditis is a rare presentation. We need a very high index of clinical suspicion to diagnose the disease. It most commonly presents secondary to tuberculosis (TB) in the developing world and post-radiation therapy in the developed world. Classically, it presents with symptoms of heart failure and as pericardial thickening or calcification on imaging studies. In hospital settings, constrictive pericarditis is not usually considered as a differential in patients presenting with pleural effusion...
April 9, 2018: Curēus
Jai-Wun Park, Horst Sievert, Caroline Kleinecke, Laura Vaskelyte, Steffen Schnupp, Kolja Sievert, Yat-Yin Lam, Barbara E Stähli, Deyuan Zhang, Anning Li, Johannes Brachmann
BACKGROUND: We here report the first European experience with the novel LAmbre left atrial appendage (LAA) occluder, a self-expanding device consisting of an umbrella and a cover connected by a central waist. METHODS AND RESULTS: A total of 60 patients (74.4 ± 8.3 years; 66.7% men; CHA2DS2-VASc: 4.0 ± 1.6, HAS-BLED score: 3.2 ± 1.3) with atrial fibrillation and contraindications to oral anticoagulation underwent left atrial appendage occlusion (LAAO) with the LAmbre device at two German centers between November 2013 and September 2015...
August 15, 2018: International Journal of Cardiology
Christel Gerardin, Arthur Mageau, Khadija Benali, Fanny Jouan, Gregory Ducrocq, Jean-Francois Alexandra, Damien van Gysel, Thomas Papo, Karim Sacre
OBJECTIVES: We aimed to evaluate the prognostic value of FDG pericardial uptake using FDG-PET/CT in patients admitted for acute pericarditis with pericardial effusion. METHODS: In this monocentric retrospective cohort study, all patients admitted for idiopathic acute pericarditis with pericardial effusion from January 2009 to December 2016 who underwent a FDG-PET/CT at diagnosis were considered. Pericardial FDG uptake was measured by generating a volume of interest to calculate the maximal standardized uptake value...
May 31, 2018: International Journal of Cardiology
Nikhil Yegya-Raman, Kyle Wang, Sinae Kim, Meral Reyhan, Matthew P Deek, Mutlay Sayan, Diana Li, Malini Patel, Jyoti Malhotra, Joseph Aisner, Lawrence B Marks, Salma K Jabbour
HYPOTHESIS: We hypothesized that higher cardiac doses correlates with clinically significant cardiotoxicity after standard-dose chemoradiation therapy (CRT) (∼60 Gy) for inoperable non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the records of 140 patients with inoperable NSCLC treated with concurrent CRT from 2007-2015. Extracted data included baseline cardiac status, dosimetric parameters to the whole heart (WH) and cardiac substructures, and the development of post-CRT symptomatic cardiac events (acute coronary syndrome [ACS], arrhythmia, pericardial effusion, pericarditis, and congestive heart failure [CHF])...
June 5, 2018: Journal of Thoracic Oncology
Ahmed Abdelhafez, Nancy Wassef, Kai Hogrefe, Mohsin Farooq
A 41-year-old woman was visiting Oxford, where she had a sudden cardiac arrest. Cardiopulmonary resuscitation was started by a bystander until the paramedics arrived, who found her in ventricular fibrillation, and delivered three shocks. After 28 min she had return of spontaneous circulation. Emergency coronary angiography revealed normal coronary arteries. Echocardiography followed by a cardiac MRI showed non-dilated left ventricles with no evidence of late gadolinium enhancement. She had a single-chamber implantable-cardioverter defibrillator (ICD)...
June 6, 2018: BMJ Case Reports
José Ramón López-Mínguez, Reyes González-Fernández, Juan Manuel Nogales-Asensio, Bruno Bengla-Limpo, Ana Martínez-Carapeto, Damián Sánchez-Quintana
No abstract text is available yet for this article.
June 11, 2018: JACC. Cardiovascular Interventions
Malay Sarkar, Rajeev Bhardwaz, Irappa Madabhavi, Srinivas Gowda, Kushal Dogra
OBJECTIVES: Reviewed the etiologies, pathophysiologic mechanisms, detection and clinical significance of pulsus paradoxus in various conditions. DATA SOURCE: We searched PubMed, EMBASE, and the CINAHL from inception to June 2017. We used the following search terms: Pulsus paradoxus, pericardial effusion, acute asthma, ventricular interdependence and so forth. All types of study were chosen. RESULTS AND CONCLUSION: Legendary physician Sir William Osler truly said that "Medicine is learned by the bedside and not in the classroom...
June 5, 2018: Clinical Respiratory Journal
Neda Irenji, Suresh Kumar Gopala Pillai, Jennifer Susan West-Jones
Groin pain is a frequently occurring complaint in presentations to the Emergency Department. Muscular sprain is often a differential diagnosis, however serious conditions such as pyomyositis should not be ignored. This case report presents a child with atraumatic right groin pain, which was initially diagnosed as a muscular sprain. The patient later re-presented out of hours to the Emergency Department with what was found to be extensive pelvic abscesses. He was subsequently found to have bilateral pneumonia and later developed a pericardial effusion and osteomyelitis of the right iliac bone, sacroiliac joint and sacrum...
June 5, 2018: BMJ Case Reports
Zhaoxin Mike Yang, Elizabeth Pontius, Sakib Motalib, Jonathan E Davis
No abstract text is available yet for this article.
June 2, 2018: Journal of Emergency Medicine
Nidhi Gulati, Rachel Katie Morris, Denise Williams, Mark David Kilby
Lymphoedema-distichiasis is an inherited autosomal dominant disorder of the lymphatic system. Rarely, it is associated with fetal hydrops; the risk and severity of which increases with successive generations. The causative gene is a member of the forkhead transcription factor family ( FOXC2 ). We describe a fetus presenting with early-onset, rapidly progressing body wall oedema, bilateral pleural effusions and a pericardial effusion in a mother with known FOXC2 mutation. First trimester chorionic villus sampling confirmed FOXC2 mutation in the fetus when there was only a large nuchal translucency...
June 4, 2018: BMJ Case Reports
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