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Filiz Kizilirmak, Gultekin Gunhan Demir, Beytullah Cakal, Hüseyin Saffet Bekoz, Fatih Erkam Olgun
Evans syndrome (ES) is a rare hematological disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and/or neutropenia, all of which may be seen simultaneously or subsequently. Thrombotic events in ES are uncommon. Furthermore, non-ST segment-elevation myocardial infarction (NSTEMI) during ES is a very rare condition. Here, we describe a case of a 69-year-old female patient presenting with NSTEMI and ES. Revascularization via percutaneous coronary intervention (PCI) was scheduled and performed...
September 2016: Indian Heart Journal
A Rougé, J Wintzer-Wehekind, B Demailly, M Abdellaoui, B Faurie, J Monségu
Purulent pericarditis seldom occurs in Western countries, yet its mortality rate remains high between 20 and 35 % despite early treatment. We report the case of a 43-year-old patient admitted in the intensive cardiologic care unit with a pre-tamponade, requiring an immediate percutaneous pericardiocentesis allowing the drainage of a purulent effusion. Evolution with antibiotic therapy adapted according to the bacteriological findings was favorable and 3-months follow-up shows a near complete regression of the effusion...
October 5, 2016: Annales de Cardiologie et D'angéiologie
Christie J Bruno, Kristen M Glass
The purpose of this review is to explore low-cost options for simulation and training in neonatology. Numerous cost-effective options exist for simulation and training in neonatology. Lower cost options are available for teaching clinical skills and procedural training in neonatal intubation, chest tube insertion, and pericardiocentesis, among others. Cost-effective, low-cost options for simulation-based education can be developed and shared in order to optimize the neonatal simulation training experience.
September 30, 2016: Seminars in Perinatology
Romolo Gaspari, Anthony Weekes, Srikar Adhikari, Vicki E Noble, Jason T Nomura, Daniel Theodoro, Michael Woo, Paul Atkinson, David Blehar, Samuel M Brown, Terrell Caffery, Emily Douglass, Jacqueline Fraser, Christine Haines, Samuel Lam, Michael Lanspa, Margaret Lewis, Otto Liebmann, Alexander Limkakeng, Fernando Lopez, Elke Platz, Michelle Mendoza, Hal Minnigan, Christopher Moore, Joseph Novik, Louise Rang, Will Scruggs, Christopher Raio
BACKGROUND: Point-of-care ultrasound has been suggested to improve outcomes from advanced cardiac life support (ACLS), but no large studies have explored how it should be incorporated into ACLS. Our aim was to determine whether cardiac activity on ultrasound during ACLS is associated with improved survival. METHODS: We conducted a non-randomized, prospective, protocol-driven observational study at 20 hospitals across United States and Canada. Patients presenting with out-of-hospital arrest or in-ED arrest with pulseless electrical activity or asystole were included...
September 28, 2016: Resuscitation
Lisa A Murphy, Cynthia M Panek, Domenico Bianco, Reid K Nakamura
OBJECTIVE: To describe the utility of Yunnan Baiyao (YB) alone or in combination with epsilon aminocaproic acid (EAC) for the treatment of dogs with echocardiographically identified right atrial (RA) masses and pericardial effusion (PE). DESIGN: Retrospective case-controlled study. SETTING: Two private practice referral hospitals. ANIMALS: Client-owned dogs with RA masses and PE identified echocardiographically over a 3-year period...
September 26, 2016: Journal of Veterinary Emergency and Critical Care
Benjamin James Kurth, Vanya Wagler, Michael Keith
In connective tissue disorders, the incidence of pericardial disease and pericardial effusion can be up to 58%, and if untreated, it can lead to cardiac tamponade which can be fatal. Physicians must have a high index of suspicion for this disease as diagnosis can be delayed while evaluating more common causes of tachycardia and hypotension in the immunosuppressed (ie, sepsis). We present a 55-year-old woman with a severe case of dermatomyositis, marked by significant weight loss, a bedridden state and hallmark cutaneous findings...
2016: BMJ Case Reports
Fahad Almehmadi, Mark Chandy, Kim A Connelly, Jeremy Edwards
Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse...
2016: Case Reports in Cardiology
Igor Belluschi, Micaela Cioni, Stefano Moriggia, Ottavio Alfieri
Takotsubo cardiomyopathy is a reversible cardiomyopathy, which generally developes in menopausal women and is characterized by left ventricle dysfunction with apical ballooning in the absence of coronary artery disease. It is often triggered by a stressful event, and its clinical presentation resembles acute anterior myocardial infarction. This condition is a rare adverse event of cardiac operations, and only a few cases are described in the literature, especially after mitral valve operations. We report the case of a 69-year-old man who underwent aortic valve repair and ascending aorta replacement, followed by pericardial effusion 6 months later, requiring pericardiocentesis resulting in Takotsubo cardiomyopathy...
October 2016: Annals of Thoracic Surgery
Chance M Witt, Charles J Lenz, Henry H Shih, Elisa Ebrille, Andrew N Rosenbaum, Htin Aung, Martin van Zyl, Kevin K Manocha, Abhishek J Deshmukh, David O Hodge, Siva K Mulpuru, Yong-Mei Cha, Raul E Espinosa, Samuel J Asirvatham, Christopher J McLeod
PURPOSE: Optimal atrial pacemaker lead position and fixation mechanism have not been determined with regard to effect on complications. We aimed to determine the association between atrial lead-related complications and varying atrial lead tip positions and lead fixation mechanisms. METHODS: All patients who underwent dual-chamber pacemaker implant between 2004 and 2014 were retrospectively reviewed for atrial lead tip position and fixation type. Lead-related complications were assessed by electronic medical record review...
September 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Jorge Alvarado Socarras, Juan P Rojas Torres, José A Vargas Soler, Carlos Guerrero
Invasive fungal infections are a considerable cause of morbidity, mortality, increased hospital stay durations, and high health care costs, during neonatal period. In this period, the premature infants are the most affected. Candida species are the leading cause of invasive fungal infections. The majority of neonatal Candida infections are caused by C. albicans, C. parapsilosis, C. glabrata and C. tropicalis, although other fungus species are being reported. One such emerging pathogen is K. ohmeri. This organism has been reported as a pathogen in the neonatal period, principally in premature infants...
October 1, 2016: Archivos Argentinos de Pediatría
Sankalp Dwivedi, Fayez Siddiqui, Milan Patel, Shaun Cardozo
Central venous catheter (CVC) insertion rarely causes cardiac tamponade due to perforation. Although it is a rare complication, it can be lethal if not identified early. We report a case of cardiac tamponade caused by internal jugular (IJ) central venous catheter (CVC) insertion using a soft J-tipped guide wire which is considered safe and rarely implicated with cardiac tamponade. A bedside transthoracic echocardiogram (TTE) revealed a pericardial effusion with tamponade. An emergent bedside pericardiocentesis was done revealing bloody fluid and resulted in clinical stabilization...
2016: Case Reports in Critical Care
Kensuke Kobayashi, Yukio Suto, Okihiko Akashi, Yoshihito Sakata, Yasufumi Hayama, Junichi Kon, Osamu Chino
We report a case of pericardial fenestration in a patient with myocardial metastasis and cardiac tamponade after surgery for esophageal cancer. A 66-year-old man had been suffering from orthopnea, hypotension and general malaise due to cardiac tamponade and heart failure. Esophagectomy was performed with substernal gastric tube reconstruction for advanced esophageal carcinoma. Nine months after the operation, heart failure developed, and myocardial and pericardial metastasis was subsequently detected. Subxiphoidal pericardiocentesis was abandoned due to the substernal gastric tube, and pericardial fenestration was performed through a small left anterior thoracotomy at the 5th intercostal space...
September 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Maiko Kuroda, Masashi Amano, Soichiro Enomoto, Makoto Miyake, Hirokazu Kondo, Toshihiro Tamura, Kazuaki Kaitani, Chisato Izumi, Yoshihisa Nakagawa
Pericardiocentesis is performed to treat cardiac tamponade or diagnose the cause of pericardial effusion. Cardiogenic shock with right ventricular (RV) dysfunction is a rare complication after pericardiocentesis. We report a case of an 82-year-old man who suddenly suffered cardiopulmonary arrest 12 h after pericardiocentesis. A transthoracic echocardiogram showed remarkable RV dysfunction and tricuspid valve dysfunction. Tricuspid valve closure was severely impaired, and the tricuspid regurgitation signal showed laminar flow with an early peak...
October 2016: Journal of Medical Ultrasonics
I Ates, M Kaplan, N Yilmaz
OBJECTIVE: While non-symptomatic pericardial effusion is seen in primary hypothyroidism, massive pericardial effusion is a very rare finding. In the literature, newly diagnosed primary hypothyroidism cases presenting with massive pericardial effusion or acute renal failure are present, but we did not encounter any case first presenting with combination of two signs. In this case report, primary hypothyroidism case that presenting with massive pericardial effusion and acute renal failure will be discussed...
January 2016: Endocrine Regulations
Igal Kushnir, Ido Wolf
Nivolumab, a programmed death 1 (PD1) inhibitor, belongs to a family of drugs known as immune checkpoint inhibitors that share a similar toxicity profile, which includes rash, pruritus, colitis, hepatitis, pneumonitis and thyroid dysfunction. Nivolumab has a proven efficacy in the treatment of malignant melanoma, non-small cell lung cancer and renal cell carcinoma. We present the case of a 67-year-old male patient with metastatic squamous cell carcinoma of the lung who suffered from a massive pericardial effusion secondary to treatment with nivolumab, which he began in June 2015...
August 24, 2016: Cardiology
Nebojša Mujović, Milan Marinković, Nebojša Marković, Aleksandar Kocijančić, Vladan Kovačević, Dragan Simić, Arsen Ristić, Goran Stanković, Biljana Miličić, Svetozar Putnik, Bosiljka Vujisić-Tešić, Tatjana S Potpara
INTRODUCTION: Cardiac tamponade (CT) is a life-threatening complication of radiofrequency ablation (RFA). The course and outcome of CT in low-to-medium volume electrophysiology centers are underreported. METHODS: We analyzed the incidence, management and outcomes of CT in 1500 consecutive RFAs performed in our center during 2011-2016. RESULTS: Of 1500 RFAs performed in 1352 patients (age 55 years, interquartile range: 41-63), 569 were left-sided procedures (n = 406 with transseptal access)...
October 2016: Advances in Therapy
Jawaher Al-Jalahma, Wejdan Al-Hakami, Yazan Musayab, Tariq Ismail, Rajasekharan Nair, Khalid Bin Thani
A 46-year-old man experienced a remote unexpected lung injury with a sharp object. The object migrated over the years, penetrating the mediastinal structure, injuring the pericardium and the right-sided chambers of the heart. The injury was complicated by hemodynamic instability and pericardial tamponade. An emergent pericardiocentesis followed by thoracotomy, foreign body extraction, and puncture site closure. This is a very rare case of remote penetrating lung injury with a dormant course.
September 2016: Annals of Thoracic Surgery
Vladimir Lakhter, Vikas Aggarwal, Riyaz Bashir, Brian O'Murchu, Howard A Cohen, Brian P O'Neill
OBJECTIVES: To compare procedural success and safety of pericardiocentesis using continuous ultrasonographic visualization of a long (7 cm) micropuncture needle to standard access with an 18 gauge needle without continuous ultrasound guidance. BACKGROUND: Current approaches to pericardiocentesis commonly utilize a large-bore 18 gauge needle for access without allowing for continuous visualization of needle entry into the pericardial space. METHODS: We included all consecutive patients at our institution who underwent pericardiocentesis between November 1, 2011 and March 3, 2016...
October 2016: Journal of Invasive Cardiology
Jon Persichino, Roger Garrison, Rajagopal Krishnan, Made Sutjita
BACKGROUND: Coxsackie B is a viral pathogen that presents with various invasive diseases in adults. Historically, the majority of adult cases with pericarditis or myocarditis have been attributed to coxsackievirus B. The presentation of this viral infection causing effusive-constrictive pericarditis, hepatitis or pancreatitis is rare. This case report is the first to describe a patient with concomitant effusive-constrictive pericarditis, hepatitis and pancreatitis from possible coxsackievirus B infection...
2016: BMC Infectious Diseases
Nirdesh Jain, Dharam Prakash Saran, Sharad Chandra Yadav, Sudhanshu Dwivedi
Ebstein's anomaly is known for its varied presentations and exceptionally long survival in some cases. Here the authors describe a case of previously undiagnosed Ebstein's anomaly in a patient who presented with massive pericardial effusion. Over the next 6 months, the patient was hospitalised twice for pericardiocentesis. To the best of our knowledge, a case of Ebstein's anomaly with recurrent massive pericardial effusion has not been described previously.
2016: BMJ Case Reports
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