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Diagnosis of cardiac tamponade

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https://www.readbyqxmd.com/read/28509710/ultrasound-guided-pericardiocentesis-a-novel-parasternal-approach
#1
Adi Osman, Tan Wan Chuan, Jamalludin Ab Rahman, Gabriele Via, Guido Tavazzi
OBJECTIVE: The aim of this study was to evaluate a novel pericardiocentesis technique using an in-plane parasternal medial-to-lateral approach with the use of a high-frequency probe in patients with cardiac tamponade. BACKGROUND: Echocardiography is pivotal in the diagnosis of pericardial effusion and tamponade physiology. Ultrasound guidance for pericardiocentesis is currently considered the standard of care. Several approaches have been described recently, which differ mainly on the site of puncture (subxiphoid, apical, or parasternal)...
May 15, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28503752/point-of-care-diagnosis-of-cardiac-tamponade-identified-by-the-flow-velocity-paradoxus
#2
William Shyy, Roneesha S Knight, Aaron Kornblith, Nathan A Teismann
The presentation of cardiac tamponade is a spectrum from occult to extreme. The clinical history, physical exam, electrocardiogram, and radiographic findings of tamponade have poor sensitivities and even worse specificities. We use a clinical scenario to demonstrate how point-of-care cardiac ultrasound can diagnose impending cardiac tamponade in a clinically stable patient. The ultrasound finding we recommend is the flow velocity paradoxus, in which respiratory variation causes significant changes in transvalvular inflow velocities, which are exaggerated when tamponade is present...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28493085/pericardial-effusion-and-cardiac-tamponade-in-the-new-millennium
#3
REVIEW
Brian D Hoit
PURPOSE OF REVIEW: The purpose of this paper is to review current approaches to the diagnosis and treatment of pericardial effusions and cardiac tamponade. RECENT FINDINGS: Recent recommendations from the American Society of Echocardiography and the European Society of Cardiology have refined our approaches to the patient with pericardial effusion and cardiac tamponade, but significant knowledge gaps remain. New diagnostic and triage strategies have been proposed, and recent data have advanced our ability to assess the presence and size of a pericardial effusion, assess its hemodynamic impact, and establish its cause...
July 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28484689/echocardiographic-evaluation-of-pericardial-effusion-and-cardiac-tamponade
#4
REVIEW
Alejandro Pérez-Casares, Sergi Cesar, Laia Brunet-Garcia, Joan Sanchez-de-Toledo
Pericardial effusion (PEff) is defined by an increase in the physiological amount of fluid within the pericardial space. It can appear following different medical conditions, mainly related to inflammation and cardiac surgery. Cardiac tamponade is a critical condition that occurs after sudden and/or excessive accumulation of fluid in the pericardial space that restricts appropriate filling of the cardiac chambers disturbing normal hemodynamics and ultimately causing hypotension and cardiac arrest. It is, therefore, a life-threatening condition that must be diagnosed as soon as possible for correct treatment and management...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28481741/cardiac-tamponade-as-initial-presentation-of-angioimmunoblastic-t-cell-lymphoma
#5
Xu Zhang, Ji Chao Zhang, Rong Xing Liu, Qi Miao
A 21-year-old man presented initially with impending cardiac tamponade secondary to an angioimmunoblastic T-cell lymphoma (AITL). Following unsuccessful pericardiocentesis and subxiphoid pericardiostomy, the patient's deteriorating hemodynamics prompted an urgent sternotomy. Histopathological diagnosis confirmed AITL. While chemotherapy remains the most effective treatment of AITL, life-threatening complications of the tumor necessitates surgical intervention.
March 6, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28473276/cardiac-tamponade-secondary-to-purulent-pericarditis-diagnosed-with-the-aid-of-emergency-department-ultrasound
#6
Mackenzie Gabler
Purulent pericarditis is a rare but devastating disease process and even when treated, carries a poor prognosis. Cardiac tamponade is the most severe complication of purulent pericarditis and without acute surgical intervention, is often fatal. Diagnosis requires pericardiocentesis; however, early consideration of the disease and its complications in the emergency department (ED) can be life-saving. Here, we present a case of an intravenous drug user who presented with altered mental status and a rectal temperature of 105...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28465998/pyopericardium-with-cardiac-tamponade-in-a-nigerian-child-with-acute-osteomyelitis
#7
Igoche David Peter, Abdullahi U Shehu, Umma A Ibrahim, Mustafa O Asani, Ibrahim Aliyu, Yunusa Sanusi, Jameel I Ahmad
In pyopericardium, pus accumulates in the pericardial space as a result of infection by pyogenic organisms, most common of which are Staphylococcus aureus and Mycobacterium tuberculosis. These patients are at risk of cardiac tamponade. Apart from pericardiocentesis in the management of these patients, definitive drug treatment may pose a formidable challenge in a setting of coinfection as in patients with tuberculosis who are predisposed to secondary bacterial infections. This was the case of our patient. We here highlight the challenges faced with etiologic diagnosis in resource-limited settings...
April 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28461805/repair-of-intrapericardial-diaphragmatic-hernia-during-aortic-surgery-in-a-78-year-old-woman
#8
Konstantinos Spiliotopoulos, Kim I de la Cruz, Georgios Gkotsis, Ourania Preventza, Joseph S Coselli
Intrapericardial diaphragmatic hernias are reported very rarely. Those of congenital origin are most often diagnosed in neonates, and those caused by indirect blunt trauma occur chiefly in adults. The latter type can be asymptomatic; however, the results of a computed tomographic scan can yield a definitive diagnosis. Once discovered, these hernias should be corrected to avoid severe sequelae such as bowel strangulation and necrosis, peritonitis, mediastinitis, and cardiac tamponade. We report the case of a 78-year-old woman who presented for elective ascending aortic aneurysm repair...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28427001/emergency-room-thoracotomy-for-acute-traumatic-cardiac-tamponade-caused-by-a-blunt-cardiac-injury-a-case-report
#9
Kenichiro Ishida, Yoshihiro Kinoshita, Nobutaka Iwasa, Masaro Nakae, Masayuki Sakaki, Yohei Ieki, Kyosuke Takahashi, Yumiko Shimahara, Taku Sogabe, Keiichiro Shimono, Mitsuhiro Noborio, Daikai Sadamitsu
INTRODUCTION: Traumatic blunt cardiac injuries have a high mortality rate, and prompt diagnosis and treatment can be lifesaving in cardiac tamponade. PRESENTATION OF CASE: A 62-year-old man was transferred to the emergency department after a motor vehicle accident. He was hemodynamically unstable. A focused assessment with sonography in trauma (FAST) showed pericardial fluid with right ventricular collapse consistent with cardiac tamponade in the subxiphoid view...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28381819/purulent-pericarditis-an-uncommon-presentation-of-a-common-organism
#10
Muhammad Kashif, Henish Raiyani, Masooma Niazi, Kamalakkannan Gayathri, Trupti Vakde
BACKGROUND In the modern antibiotic era, Streptococcus agalactiae infection of the endocardium and pericardial space is a rare occurrence. However, once the disease spreads it can lead to life-threatening illness despite advances in diagnostic and treatment modalities, partly because the symptoms and signs associated with pericarditis are frequently missing, and due to the rarity of the disease, diagnosis is often overlooked. We report an extremely rare case of purulent pericarditis caused by Streptococcus agalactiae...
April 6, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28341006/an-unusual-case-of-sudden-unexpected-death-due-to-massive-hemopericardium-from-primary-mediastinal-seminoma
#11
Supot Puanglumyai, Suree Lekawanvijit
It is well-known that cardiovascular disease is the most common cause of sudden unexpected death, especially in the young. However complete postmortem investigation performed by qualified forensic pathologists is crucial in establishing the exact cause and manner of death. Sudden death caused by a cardiac tamponade occurring secondarily to a primary mediastinal tumor is extremely unusual. An autopsy on a 25-year-old man who died unexpectedly discovered a massive hemopericardium in association with an anterosuperior mediastinal mass...
January 2017: Forensic Science International
https://www.readbyqxmd.com/read/28340603/blunt-cardiac-injury-due-to-trauma-associated-with-snowboarding-a-case-report
#12
Fuminori Yamaji, Hideshi Okada, Yasuhiro Nakajima, Kodai Suzuki, Takahiro Yoshida, Yosuke Mizuno, Haruka Okamoto, Yuichiro Kitagawa, Taku Tanaka, Shiho Nakano, Sho Nachi, Tomoaki Doi, Keisuke Kumada, Shozo Yoshida, Narihiro Ishida, Katsuya Shimabukuro, Hiroaki Ushikoshi, Izumi Toyoda, Kiyoshi Doi, Shinji Ogura
BACKGROUND: Cardiac trauma is associated with a much higher mortality rate than injuries to other organ systems, even though cardiac trauma is identified in less than 10% of all trauma admissions. Here we report blunt trauma of the left atrium due to snowboarding trauma. CASE PRESENTATION: A 45-year-old Asian man collided with a tree while he was snowboarding and drinking. He lost consciousness temporarily. An air ambulance was requested and he was transported to an advanced critical care center...
March 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28316844/aspergillus-pericarditis-with-tamponade-in-a-renal-transplant-patient
#13
Sylvia Biso, Rapeepat Lekkham, Antoinette Climaco
Aspergillus pericarditis 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 of Aspergillus pericarditis with cardiac tamponade in a renal transplant patient with liver cirrhosis...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28285268/cardiac-manifestations-of-parasitic-diseases
#14
REVIEW
Maria Carmo P Nunes, Milton Henriques Guimarães Júnior, Adriana Costa Diamantino, Claudio Leo Gelape, Teresa Cristina Abreu Ferrari
The heart may be affected directly or indirectly by a variety of protozoa and helminths. This involvement may manifest in different ways, but the syndromes resulting from impairment of the myocardium and pericardium are the most frequent. The myocardium may be invaded by parasites that trigger local inflammatory response with subsequent myocarditis or cardiomyopathy, as occurs in Chagas disease, African trypanosomiasis, toxoplasmosis, trichinellosis and infection with free-living amoebae. In amoebiasis and echinococcosis, the pericardium is the structure most frequently involved with consequent pericardial effusion, acute pericarditis, cardiac tamponade or constrictive pericarditis...
May 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28258964/diagnosis-and-treatment-of-spontaneous-coronary-artery-pseudoaneurysm-rare-anomaly-with-potentially-significant-clinical-implications
#15
Subrata Kar, Richard R Webel
Spontaneous coronary artery pseudoaneurysm (PSA, false aneurysm) is an extremely rare occurrence with the precise incidence unknown. It is defined as an outwardly bulging monolayer or double layer within the coronary artery that lacks all 3 layers (intima, media, and adventitia) of the arterial wall. Coronary PSA commonly occurs from arterial dissection or perforation induced by catheter intervention, infection, pregnancy, or trauma. Traumatic dissection or perforation of the coronary artery after a percutaneous coronary intervention (PCI) remains the most common cause...
March 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28249381/echocardiography-guided-pericardiocentesis-as-the-method-of-choice-for-treatment-of-significant-pericardial-effusion-following-cardiac-surgery-a-12-year-single-centre-experience
#16
Martin Kolek, Radim Brat
BACKGROUND: There are limited contemporary data on the safety and efficacy of echo-guided pericardiocentesis following cardiac surgery in Europe. The aim of the study was to review tertiary cardiac surgery centre experience with postoperative pericardial effusion (PE) diagnosis and treatment. METHODS: A total of 6830 patients underwent open-heart surgery at our centre between December 2004 and November 2016. Of these patients, 208 (3%) required pericardiocentesis for significant PE...
March 1, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28243766/every-second-counts-signs-of-a-failing-heart-on-thoracic-ct-in-the-ed
#17
David J Maldow, Abhishek Chaturvedi, Katherine Kaproth-Joslin
Impending cardiac failure is often difficult to recognize and requires a multidisciplinary approach. Upon arrival in the emergency department, patients are promptly screened for potentially life-threatening conditions through a history and physical examination. In many cases, the diagnosis is not clear until confirmatory laboratory or imaging tests are performed. Unfortunately, patients can rapidly decompensate as this diagnostic information is being obtained. Emergent CT plays a key role in identifying conditions that may result in cardiovascular collapse, including severe congestive heart failure, myocardial infarction, cardiac tamponade, and impending cardiac failure...
June 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28237383/the-curious-case-of-a-cardiac-tamponade-in-the-hypertensive-patient-presenting-as-abdominal-fullness
#18
William Li, Rogin Subedi, Bhaskara Madhira
Cardiac tamponade is a medical emergency consisting of an accumulation of fluid in the pericardial space which is rapidly progressing and fatal. Because cardiac tamponade is ultimately a clinical diagnosis, mindful consideration for atypical presentations is essential for the reduction of mortality in the acute setting. Our patient was a 77year-old female admitted after presenting with general malaise, weakness, somnolence, altered mental status and urinary incontinence found to have CML (chronic myeloid leukemia) on confirmatory bone marrow biopsy after suspicions arose from a leukocytosis of 34,000 cells per mcL with 85% neutrophils and elevated blasts (8%)...
January 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28222655/a-cytologic-diagnosis-of-braf-v600e-erdheim-chester-disease-on-pericardial-fluid
#19
P Chasseur, M Kyriakopoulou, B Vokaer, I Beukinga, R Casado Arroyo, E Cogan, B Couturier
We report the case of a 74-year-old woman admitted to the emergency unit for resting dyspnea. Clinical presentation, cardiac MRI and echocardiography were consistent with cardiac tamponade requiring emergency pericardiocentesis. Cytologic examination of the pericardial fluid revealed the presence of CD68(pos) CD1a(neg) S100(neg) foamy histiocytes (Fig. 1). Additional investigations complied with the diagnosis of Erdheim-Chester histiocytosis. Treatment with αIFN was initiated but the patient developed severe neutropenia that contraindicated further administration...
February 22, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28185680/recurrent-pericarditis
#20
M Imazio, A Battaglia, L Gaido, F Gaita
Recurrent pericarditis is the most troublesome complication of pericarditis occurring in 15 to 30% of cases. The pathogenesis is often presumed to be immune-mediated although a specific rheumatologic diagnosis is commonly difficult to find. The clinical diagnosis is based on recurrent pericarditis chest pain and additional objective evidence of disease activity (e.g. pericardial rub, ECG changes, pericardial effusion, elevation of markers of inflammation, and/or imaging evidence of pericardial inflammation by CT or cardiac MR)...
May 2017: La Revue de Médecine Interne
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