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malignant pericardical effusion

Shane Patrick Flood, Omar Ayah, Satoshi Furukawa, Robert B Norris
A 67-year-old man presented with 3 months of exertional dyspnoea and 1 week of oedema. Examination revealed elevated neck veins, pulsus paradoxus, muffled heart sounds, decreased breath sounds and pedal oedema. Transthoracic echocardiogram (TTE) demonstrated cardiac tamponade, and chest X-ray showed pleural effusion. Pericardiocentesis, thoracocentesis, laboratory investigations and CT did not elucidate an underlying aetiology. Three weeks later, he presented with recurrent cardiac tamponade and pleural effusion...
January 18, 2017: BMJ Case Reports
Valery Istomin, David S Blondheim, Simcha R Meisel, Aaron Frimerman, Moshe Lapidot, Ronit Rachmilevitch
This case report describes a 37-year-old female who was admitted to our Emergency Department because of shortness of breath. On physical examination, she had dyspnea and tachycardia and blood pressure was 80/50 mmHg with a pulsus paradoxus of 22 mmHg. Neck veins were distended, heart sounds were distant, and dullness was found on both lung bases. Her chest X-ray revealed bilateral pleural effusion and cardiomegaly. On both computed tomography and echocardiography the heart was of normal size and a large pericardial effusion was noted...
2016: Case Reports in Medicine
Khushboo Goel, Huthayfa Ateeli, Neil M Ampel, Dena L'heureux
BACKGROUND Cardiac tamponade caused by pericardial effusion has a high mortality rate; thus, it is important to diagnose and treat this condition immediately. Specifically, bacterial pericarditis, although now very rare, is often fatal because of its fulminant process. CASE REPORT We present a case of a 61-year-old man with metastatic small cell lung cancer undergoing chemotherapy who presented with fatigue, poor appetite, and altered mental status. He was found to have a large-volume pericardial effusion with tamponade physiology...
July 22, 2016: American Journal of Case Reports
Fayaz A Hakim, Sujata Singh, Anil Pandit, Jorge R Alegria, John Camoriano, Melissa L Stanton, Farouk Mookadam
Interferon- α (IFN-α) alone or in combination with other chemotherapeutic agents has been used in the management of many malignant and non-malignant conditions. Pericarditis with or without pericardial effusion has been reported with IFN-α therapy, and available literature is limited to case reports. Pericardial constriction after interferon use has not been described in the published literature to date. We performed a systematic review of literature to address the demographic features, clinical presentation, diagnosis, treatment and outcome of interferon-related pericardial injury...
2014: Heart Asia
B Perek, I Tomaszewska, S Stefaniak, I Katynska, M Jemielity
Cardiac tamponade may be the first or predominant symptom of some pathologies but its etiology is not uncommonly unknown on admission to hospital. The purpose of this study was to evaluate the predominant causes of cardiac tamponade in previously healthy patients treated emergently in a single cardiac surgical center. The study involved 81 patients with the mean age of 58.1±16.0 years who underwent emergent subxyphoid pericardiotomy due to cardiac tamponade. Pericardial effusion was analyzed macro- and microscopically...
2016: Neoplasma
Hiroki Takakura, Kouichi Sunada, Kunihiko Shimizu
A 72-year-old man presented with fever, dyspnea, and weight loss. He was referred to our hospital for further examination of the cause of the pleural effusions. Chest computed tomography showed pleural effusions, a pericardial effusion, and enlarged lymph nodes in the carina tracheae. We administered treatment for heart failure and conducted analyses for a malignant tumor. The pericardial effusion improved, but the pericardium was thickened. Positron emission tomography-computed tomography (PET-CT) showed fluorine-18 deoxyglucose accumulation at the superior fovea of the right clavicle, carina tracheae, superior mediastinum lymph nodes, and a thickened pericardium...
February 2016: Kekkaku: [Tuberculosis]
Kristopher W Cummings, Daniel Green, William R Johnson, Cylen Javidan-Nejad, Sanjeev Bhalla
Given the widespread use of cross-sectional imaging modalities, specifically multidetector computed tomography and magnetic resonance, to evaluate thoracic disease, the pericardium is frequently imaged. Knowledge of the normal appearance and anatomical boundaries is vital for radiologists to avoid confusion with more sinister pathology. A variety of disorders and diseases of the pericardium can bring a patient to clinical attention from inflammatory conditions, resulting in pericarditis and pericardial effusion, to malignancy...
June 2016: Seminars in Ultrasound, CT, and MR
Erin A Gillaspie, John M Stulak, Richard C Daly, Kevin L Greason, Lyle D Joyce, Jae Oh, Hartzell V Schaff, Joseph A Dearani
OBJECTIVES: Outcome after pericardiectomy depends on many factors, but no large study has provided clarity on the effects of patient variables or cause of pericarditis on patient survival. We report early and late results from a 20-year experience with isolated pericardiectomy. METHODS: From January 1993 to December 2013, 938 patients underwent pericardiectomy at our institution. In order to establish a homogeneous population to analyze the impact of pericardiectomy, we excluded patients with prior chest radiation, malignancy, and concomitant valvular or coronary procedures...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Anirban Das, Sibes K Das, Sudipta Pandit, Rathindra Nath Karmakar
Cardiac metastases in bronchogenic carcinoma may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells, but direct invasion of heart by adjacent malignant lung mass is very uncommon. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. But direct invasion of myocardium and endocardium is very uncommon. Left atrial endocardium is most commonly involved in such cases due to anatomical contiguity with pulmonary hilum through pulmonary veins, and in most cases left atrial involvement is asymptomatic...
2016: Case Reports in Oncological Medicine
Vitorino Modesto dos Santos, Christiane Aires Teixeira, Ana Carla Andrade Almeida, Alessandra Maria Rodrigues Oliveira Santos, Kátia Rejane Marques Brito, Valerio Alves Ferreira
Yellow nail syndrome (YNS) is an uncommon condition characterized by nail changes, lymphedema, in addition to pulmonary disorders and pleural effusion. Pericarditis and non-cardiac disorders can evolve with pericardial effusions including autoimmune conditions, hypothyroidism, malignancies, tuberculosis, and uremia. A 72-year-old Brazilian woman under treatment for arterial hypertension and hypothyroidism was admitted with pericarditis and pericardial effusion concomitant with yellow nail syndrome. She denied tobacco smoking, alcohol abuse, and similar disorders in her family...
December 2015: Acta Medica Iranica
Kazufumi Yoshida, Shinji Teramoto
A 68-year-old man was diagnosed with non small cell lung cancer in May 2013. Although the patient was negative for EGFR mutation, he wished to undergo treatment with gefitinib and erlotinib as first-line therapy. However, one year later, he was admitted to our hospital because of cardiac tamponade due to malignant pericarditis. He received pericardial drainage, after which his condition was stabilized. He was diagnosed with lung adenocarcinoma by cytology of pericardial effusion and treated with pemetrexed plus cisplatin as second-line therapy...
2015: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
B Maisch
Eleven years after the publication of the first guidelines worldwide on pericardial diseases by the European Society of Cardiology (ESC), the international expert group of the ESC has updated the original document of 28 pages with 275 references. The final version of the new guidelines is more voluminous with 44 pages of recommendations but only 233 references. A continuing medical education (CME) certified update of the 2004 guidelines was published in the journal Herz volume 7/2014. In comparison to 2004 the 2015 guidelines have remained virtually unchanged in the sections detailing diagnostics, differential diagnosis, pathology and pathophysiology...
December 2015: Herz
Ekrem Güler, Gamze Babur Güler, Gültekin G Demir, Filiz Kızılırmak
Pericardiocentesis is a life-saving procedure performed in cardiac tamponade cases occurring in infective, inflammatory or malignancy conditions, or following percutaneous coronary intervention, cardiac device implantation or catheter ablation. In spite of advanced imaging methods, a substantial risk of complication persists. Emergent surgical intervention may be required, in particular during advancement of the catheter into the heart chambers or in cases of wall rupture. Furthermore, in all these cases, patients have a high risk of surgery because of existing comorbidities...
September 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Ichiro Akagi, Masao Miyashita, Masayoshi Hashimoto, Hiroshi Makino, Tsutomu Nomura, Keiichi Ohkawa, Yoshikazu Tsuchiya, Takashi Tajiri
We report a case of cardiac tamponade caused by metastasis from early gastric cancer. A 44-year-old woman was detected to have an abnormality of the stomach on barium meal during an annual medical checkup. Gastroendoscopy disclosed superficial depressed gastric lesions, and histopathological examination of biopsy specimens revealed the diagnosis of poorly differentiated adenocarcinoma and signet-ring cell carcinoma. Computed tomography (CT) and ultrasonography (US) revealed no evidence of metastasis. We performed distal gastrectomy with regional lymph node dissection...
October 2008: Clinical Journal of Gastroenterology
Matthew Chak Hin Szeto, Benjamin Disney, Philip Perkins, Gordon Wood
We describe a case of a 43-year-old man presenting to the gastroenterology outpatient department with exudative ascites. Mediastinal lymphadenopathy, pericardial effusion and pleural effusion were detected on further imaging. Further clinical examination revealed subcutaneous nodules on the left arm, which were confirmed to be rheumatoid nodules on histology. Inflammatory markers were elevated with positive serology for rheumatoid factor and anticyclic citrullinated protein antibody. Our investigations excluded tuberculosis, pancreatitis and malignancy in the patient...
2015: BMJ Case Reports
Radu Crişan-Dabija, Traian Mihăescu
The Yellow Nail Syndrome is a rare clinical entity, first described in 1967 by P.D. Samman and W.F. White. The triad slow-growing dystrophic yellow nails, lymphedema and chronic respiratory disorders is the typical manifestation of the disease but some variations have been described as well as associations with chylothorax, chylous ascites, intestinal lymphangiectasia, thyroid abnormalities, malignancies and immunoglobulin A (IgA) deficiency. We present a case of a 55-years-old woman that had an insidious onset of respiratory disorders and chronic sinusitis, suspected to be infectious throughout the hospitalizations, associated with therapeutically neglected autoimmune thyroiditis...
January 2015: Pneumologia: Revista Societății Române de Pneumologie
Feridoun Sabzi, Reza Faraji
INTRODUCTION: Pathological involvement of pericardium by any disease that resulting in effusion may require decompression and pericardiectomy. The current article describes rare patients with effusion who after pericadiectomy and transient hemodynamic improvement rapidly developed progressive heart failure and subsequent multi organ failure. METHODS: During periods of five years, 423 patients in our hospital underwent pericardiotomy for decompression of effusion...
2015: Journal of Cardiovascular and Thoracic Research
Esther Diana Rossi, Tommaso Bizzarro, Fernando Schmitt, Adhemar Longatto-Filho
BACKGROUND: Fine-needle aspiration cytology (FNAC) of serous membrane effusions may fulfil a challenging role in the diagnostic analysis of both primary and metastatic disease. From this perspective, liquid-based cytology (LBC) represents a feasible and reliable method for empowering the performance of ancillary techniques (ie, immunocytochemistry and molecular testing) with high diagnostic accuracy. METHODS: In total, 3171 LBC pleural and pericardic effusions were appraised between January 2000 and December 2013...
April 2015: Cancer Cytopathology
Wenhui Gong, Xiaofeng Ye, Kaihu Shi, Qiang Zhao
Primary malignant pericardial mesothelioma (PMPM) is an extremely rare, highly lethal and often misdiagnosed tumor. We report a 60-year-old woman complaining of dry cough, shortness of breath and exertional dyspnea due to a large pericardial effusion. The pericardial fluid volume declined after pericardiocentesis; analysis of the fluid revealed malignant cells and was negative for tuberculosis. Subsequently, the patient developed a compression of the superior vena cava and pericardial constriction. The patient's symptoms marginally improved after partial pericardiectomy, and a diagnosis of pericardial mesothelioma was made on pathology...
December 2014: Journal of Thoracic Disease
Liliana Marta, Miguel Alves, Marisa Peres, Ricardo Ferreira, Hugo Ferreira, Margarida Leal, Ângelo Nobre
Constrictive pericarditis is a clinical condition characterized by the appearance of signs and symptoms of right heart failure due to loss of pericardial compliance. Cardiac surgery is now one of the most frequent causes in developed countries, while tuberculosis remains the most prevalent cause in developing countries. Malignancy is a rare cause but usually has a poor prognosis. The diagnosis of constrictive pericarditis remains a clinical challenge and requires a combination of noninvasive diagnostic methods (echocardiography, cardiac magnetic resonance and computed tomography); in some cases, cardiac catheterization is needed to confirm the diagnosis...
January 2015: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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