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2.
Pan Afr Med J ; 33: 156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565118

RESUMO

Cardiac manifestations develop in the majority of patients with systemic lupus erythematosus (SLE) at some time during the course of their disease. This study was designed to assess cardiac abnormalities in patients with SLE by echocardiography and to compare the 2 groups of patients with and without cardiac manifestations. It was a transversal, descriptive study, conducted in the Internal Medicine Department at the Military Hospital of Tunis from January 2016 to June 2018. Eighty lupus patients, diagnosed on the basis of ACR (American college of rheumatology) criteria, were enrolled in the study and were evaluated by standard echocardiography with color Doppler. Out of 80 patients 42 (52%) had abnormal echocardiographic findings. Pericardial effusion was found in 55%, valvular abnormalities in 52% and 38% had pulmonary hypertension. Patients with pleural effusion (45 vs 15%) were more vulnerable to cardiac involvement as well as renal impairment (57 vs 44%). The difference, however, were not statistically significant (p>0.05) in the renal involvement. Active disease with low complement (80%) was associated with higher frequency of cardiac involvement than disease in remission (64%) but the result was not statistically significant (p=0.11). Cardiac abnormalities are very common in lupus patients even when clinically asymptomatic form. Echocardiography is an excellent non-invasive tool for cardiac evaluation. Their research must be systematic with echocardiography in order to reduce subsequent cardiac morbidity and mortality among the lupus patients.


Assuntos
Ecocardiografia/métodos , Cardiopatias/diagnóstico por imagem , Lúpus Eritematoso Sistêmico/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Cardiopatias/epidemiologia , Cardiopatias/etiologia , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/etiologia , Hospitais Militares , Humanos , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/epidemiologia , Derrame Pericárdico/etiologia , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/epidemiologia , Derrame Pleural/etiologia , Tunísia
3.
Cardiovasc Pathol ; 43: 107149, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31639653

RESUMO

PURPOSE: The aims of this study were, firstly, to determine the relationship of left ventricular wall thickness (LVWT) measurements between postmortem computed tomography (PMCT) and postmortem magnetic resonance imaging (PMMR) and, secondly, to assess the utility of postmortem imaging for LVWT measurements compared to autopsy. MATERIALS AND METHODS: All cases ≥18years old, with postmortem interval ≤4days, cardiac PMCT, PMMR, and full forensic autopsy, were reviewed in our database retrospectively. Exclusion criteria were gas accumulations in the myocardial wall and cardiac trauma. LVWT on PMCT and PMMR was assessed. The measurements were repeated by the same rater after 2months. Autopsy reports were reviewed, and LVWT and pericardial fluid volume measured at autopsy were noted. Pericardial fluid volume >50ml was determined positive for pericardial effusion. RESULTS: A total of 113 cases were included in the study. Twelve cases had pericardial effusion. Intrarater reliability for imaging based LVWT was excellent. LVWT (free wall) was significantly larger on PMCT (18.3mm) compared to PMMR (17.6mm), but these measurements correlated positively. LVWT (anterior wall) was significantly larger on PMMR (15mm) than at autopsy (14mm), and these measurements also correlated positively. Pericardial effusions led to larger differences between PMMR and autopsy measurements, however without statistical significance. DISCUSSION: There exist discrepancies between LVWT as measured on postmortem imaging and at autopsy. Specialists should be aware in order to not misinterpret imaging measurements.


Assuntos
Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/patologia , Imagem por Ressonância Magnética , Tomografia Computadorizada Multidetectores , Miocárdio/patologia , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/patologia , Adulto , Idoso , Autopsia , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Mudanças Depois da Morte , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos
4.
Am J Case Rep ; 20: 1382-1386, 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31534113

RESUMO

BACKGROUND Umbilical venous catheter (UVC) insertion is a standard of care in neonatal units. Pericardial effusion, one of the rare but fatal complications of UVC insertion, requires rapid diagnosis and management, and saline contrast echocardiography may enable effective diagnosis. Here, we have reported on the case of pericardial effusion after UVC insertion, highlighted the use of saline contrast echocardiography as a diagnostic tool, and reviewed the available literature on this infrequent life-threatening complication. CASE REPORT A 31-week-old preterm male infant developed a life-threatening cardiac tamponade 1 day after UVC insertion. Pericardiocentesis was performed, and saline contrast echocardiography confirmed the diagnosis. CONCLUSIONS We concluded that pericardial effusion and tamponade should be considered in neonates with a central line who develop sudden and unexplained deterioration. Saline contrast echocardiography can confirm the optimal position of central lines and diagnose pericardial effusion related to UVC insertion.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Cateterismo Venoso Central/efeitos adversos , Ecocardiografia , Derrame Pericárdico/diagnóstico por imagem , Meios de Contraste , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Pericardiocentese , Cloreto de Sódio , Veias Umbilicais
5.
J Med Case Rep ; 13(1): 301, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31543075

RESUMO

BACKGROUND: Primary effusion lymphoma is a rare, high-grade non-Hodgkin's lymphoma that usually occurs in immunosuppressed or human immunodeficiency virus-positive individuals in advanced stages of the disease. However, primary effusion lymphoma occasionally affects immunocompetent patients who are infected with human herpes virus type 8 or Epstein-Barr virus. This disease manifests with liquid collections in cavities, producing constitutional symptoms; fever; weight loss; and symptoms related to extrinsic compression, such as dyspnea or abdominal discomfort. Diagnosis is confirmed with cytological or tissue evaluation showing large, multinucleated lymphoid cells with positive specific markers for the disease, such as CD45 and markers related to viral infections, when present. There is no standard treatment for primary effusion lymphoma, but several chemotherapy protocols are recommended, usually with poor results. CASE PRESENTATION: We present a case of an adult human immunodeficiency virus-negative Hispanic origin woman with primary effusion lymphoma with pleuritic, pericardial, and peritoneal compromise who also had unusual complications during a diagnostic procedure: the accidental rupture of the left ventricle and the development of a secondary left ventricular pseudoaneurysm. We describe the clinical, radiological, and laboratory characteristics as well as the outcome of this case. CONCLUSIONS: Primary effusion lymphoma is a very rare entity that represents 4% of non-Hodgkin's lymphoma cases associated with human immunodeficiency virus and 0.1% to 1% of all lymphomas in patients with another type of immunodeficiency in regions where human herpes virus type 8 is not endemic. This reported case is an unusual presentation of primary effusion lymphoma because it occurred in an immunocompetent human immunodeficiency virus-negative adult woman without the presence of Kaposi's sarcoma or Castleman's disease and for whom the clinical course after chemotherapy was successful. However, the rupture of the free wall of the left ventricle is a very rare catastrophic event that usually occurs after myocardial infarction. Left ventricle free wall rupture rarely goes unnoticed, but when it occurs, it leads to the development of a ventricular pseudoaneurysm in which the rupture is contained by the pericardium with an organized thrombus and an adjacent hematoma.


Assuntos
Traumatismos Cardíacos/etiologia , Ventrículos do Coração/lesões , Doença Iatrogênica , Linfoma de Efusão Primária/diagnóstico , Toracoscopia/efeitos adversos , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Feminino , Humanos , Imunocompetência , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem , Tomografia Computadorizada por Raios X
6.
Heart Surg Forum ; 22(4): E287-E288, 2019 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-31398093

RESUMO

The rupture of sinus of Valsalva aneurysm (SVA) into the pericardial cavity is extremely rare and fatal. A 52-year-old man presented with an abrupt onset of chest pain and dizziness. An echocardiography and a computed tomographic angiography revealed a giant aneurysm of the noncoronary sinus (NCS) (maximum, 70 mm) and pericardial effusion in favor of tamponade with a moderate degree of aortic insufficiency. On the way to the operating room, he suffered cardiac arrest, and extracorporeal cardiopulmonary resuscitation (ECPR) was initiated immediately. While he was prepared for surgery, the patient was supported by extracorporeal life support (ECLS) until cardiopulmonary bypass (CPB) was initiated. The sinus defect was reconstructed using a Dacron patch, followed by resection of the aneurysm. ECLS and CPB were discontinued successfully in the operating room. This study reports a case of an extracardiac rupture of SVA and the successful completion of surgery following ECPR.


Assuntos
Aneurisma Aórtico/cirurgia , Ruptura Aórtica/cirurgia , Reanimação Cardiopulmonar/métodos , Oxigenação por Membrana Extracorpórea/métodos , Doenças Raras/cirurgia , Seio Aórtico/cirurgia , Aneurisma Aórtico/diagnóstico por imagem , Ruptura Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/etiologia , Angiografia por Tomografia Computadorizada , Ecocardiografia Transesofagiana , Parada Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Doenças Raras/diagnóstico por imagem , Seio Aórtico/diagnóstico por imagem
7.
Am J Case Rep ; 20: 1128-1131, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31363076

RESUMO

BACKGROUND Small lymphocytic lymphoma (SLL) is a low-grade B-cell non-Hodgkin lymphoma and is the solid tumor equivalent of chronic lymphocytic leukemia (CLL) that is found in the peripheral blood. SLL typically presents with lymphadenopathy and is rarely associated with cardiac involvement. This report is of a case of lymphomatous pericardial effusion in a 61-year-old woman who presented with dyspnea. CASE REPORT A 61-year-old woman presented to the emergency department with a three-month history of worsening shortness of breath on exertion. Her symptoms progressed to shortness of breath at rest, with night sweats and chills. She had no weight loss. She was found to have a pericardial effusion, and an urgent pericardiocentesis was performed to prevent cardiac tamponade. Analysis of the pericardial fluid was consistent with a diagnosis of SLL. A bone marrow biopsy and a biopsy of a renal mass were consistent with a diagnosis of SLL. She was treated with rituximab and bendamustine with granulocyte-colony stimulating factor (G-CSF) support and was discharged home. CONCLUSIONS A case is presented of a rare association between SLL and pericardial effusion with a favorable outcome following urgent pericardiocentesis to prevent cardiac tamponade followed by chemotherapy.


Assuntos
Leucemia Linfocítica Crônica de Células B/diagnóstico , Derrame Pericárdico/etiologia , Angiografia por Tomografia Computadorizada , Dispneia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Tomografia Computadorizada por Raios X
8.
Pediatr Emerg Care ; 35(8): 575-578, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31290800

RESUMO

The differential diagnosis for patients presenting in shock can be broad, making rapid diagnosis and management challenging. We present a case of a medically complex patient with presumed septic shock, diagnosed with a large pericardial effusion with evidence of tamponade using the rapid ultrasound in shock and hypotension protocol. The point-of-care ultrasound examination allowed for more timely and definitive management.


Assuntos
Derrame Pericárdico/diagnóstico por imagem , Sistemas Automatizados de Assistência Junto ao Leito/normas , Choque/etiologia , Ultrassonografia/métodos , Adolescente , Ecocardiografia/métodos , Serviço Hospitalar de Emergência , Humanos , Masculino , Medicina de Emergência Pediátrica , Derrame Pericárdico/complicações , Derrame Pericárdico/terapia , Pericardiocentese/métodos , Choque/diagnóstico , Resultado do Tratamento
9.
Intern Med ; 58(21): 3103-3106, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31292391

RESUMO

We herein report the first case of purulent pericarditis associated with aortic stent-graft infection in an 80-year-old Japanese man that was caused by methicillin-susceptible Staphylococcus aureus, which appropriate antibiotics failed to treat. The detailed clinical course and autopsy images revealed that purulent pericarditis associated with aortic stent-graft infection caused cardiac tamponade and eventually led to mortality. We therefore suggest that surgical procedures, including drainage, should be introduced for such cases.


Assuntos
Aorta/cirurgia , Pericardite/microbiologia , Infecções Estafilocócicas/complicações , Staphylococcus aureus , Stents/microbiologia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Aorta/microbiologia , Aorta/patologia , Tamponamento Cardíaco/etiologia , Evolução Fatal , Humanos , Masculino , Meticilina/uso terapêutico , Derrame Pericárdico/diagnóstico por imagem , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/patologia , Staphylococcus aureus/efeitos dos fármacos , Tomografia Computadorizada por Raios X , Falha de Tratamento
10.
Emerg Med Clin North Am ; 37(3): 409-430, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31262412

RESUMO

Resuscitative ultrasound describes point-of-care applications that provide diagnostic information, physiologic monitoring, and procedural guidance in critically ill patients. This article reviews the evaluation of ventricular function, identification of pericardial effusion and tamponade, evaluation of preload and fluid responsiveness, and hemodynamic monitoring, as some of the main applications where this modality can help emergency physicians during resuscitation of critically ill patients.


Assuntos
Ecocardiografia Transesofagiana , Ventrículos do Coração/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Sistemas Automatizados de Assistência Junto ao Leito , Ressuscitação , Velocidade do Fluxo Sanguíneo , Tamponamento Cardíaco/diagnóstico por imagem , Estado Terminal , Medicina de Emergência , Serviço Hospitalar de Emergência , Hemodinâmica , Humanos , Monitorização Fisiológica , Derrame Pericárdico/diagnóstico por imagem , Ultrassonografia , Ultrassonografia Doppler , Veia Cava Inferior/diagnóstico por imagem , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Direita/diagnóstico por imagem
11.
BMJ Case Rep ; 12(7)2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31308193

RESUMO

Sirolimus is an important immunosuppressive drug in renal transplantation but contains numerous side effects. In this study, we describe a case of renal transplant recipient treated with sirolimus who developed pericardial effusion associated with interstitial pneumonia. An extensive search for alternative causes were all negative, and all symptoms disappeared after sirolimus interruption. Therefore, this case demonstrates that sirolimus can cause pericardial effusion possibly through a proinflammatory mechanism.


Assuntos
Imunossupressores/efeitos adversos , Transplante de Rim , Derrame Pericárdico/induzido quimicamente , Sirolimo/efeitos adversos , Diagnóstico Diferencial , Substituição de Medicamentos , Feminino , Glomerulonefrite/cirurgia , Humanos , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Complicações Pós-Operatórias/induzido quimicamente , Complicações Pós-Operatórias/diagnóstico por imagem , Transplantados , Resultado do Tratamento
12.
BMJ Case Rep ; 12(7)2019 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-31331930

RESUMO

Haemolytic disease of the fetus and newborn (HDFN) is associated with red cell antibodies. Anti-M usually results in a mild haemolysis and is rarely clinically significant. There is no established consensus on management of pregnancies with anti-M. A case of recurrent HDFN with maternal M alloimmunisation was identified at a tertiary hospital in Australia. We collected the patient and neonate's clinical and pathological data and interpreted the case with available literature. This is the first case in literature of recurrent fetal hydrops in the setting of M alloimmunisation. Neonate was delivered in a poor condition, intubated and admitted to the neonatal intensive care unit for ionotropic support, red cell transfusion and plasma transfusion for coagulopathy. Direct Coombs test was positive, confirming HDFN. Although anti-M rarely causes HDFN, accurate history, fetal surveillance and monitoring is essential for identification of fetal anaemia. Concurrent placental disease may increase fetal risk from anti-M antibodies.


Assuntos
Incompatibilidade de Grupos Sanguíneos/complicações , Eritroblastose Fetal/etiologia , Hidropisia Fetal/etiologia , Sistema do Grupo Sanguíneo MNSs , Adulto , Ascite/diagnóstico por imagem , Cardiotocografia , Teste de Coombs , Eritroblastose Fetal/sangue , Feminino , Humanos , Hidropisia Fetal/sangue , Hidropisia Fetal/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Gravidez , Recidiva
13.
Am J Case Rep ; 20: 1120-1123, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31353363

RESUMO

BACKGROUND Pericarditis is common in rheumatoid arthritis, mostly occurring as an extra-articular manifestation of the disease. We describe a patient with stable rheumatoid arthritis who presented with a large pericardial effusion and a compressive fibrotic pericardial mass. The patient had recently started treatment with a tumor necrosis factor-alpha (TNF-alpha) antagonist. CASE REPORT The patient was a 58-year-old woman with rheumatoid arthritis who presented with right ventricular compression caused by a pericardial fibrotic mass and a large pericardial effusion. The patient did not have active arthritis at the time of presentation. She had been started on treatment with a tumor necrosis factor-alpha (TNF-alpha) antagonist 4 months prior to this presentation. She was successfully treated with surgical pericardiectomy and resection of the pericardial mass. Pathologic analysis of the pericardial mass demonstrated fibrosis and no evidence of active inflammation, rheumatoid arthritis, opportunistic infection, or malignancy. CONCLUSIONS We describe a patient with stable rheumatoid arthritis who developed subacute right heart compression syndrome secondary to pericardial effusion and fibrous pericardial mass. The exact cause of pericarditis and the pericardial mass remain uncertain. There is a need for increased awareness of the association between use of TNF-alpha antagonists and the possible development of an intrapericardial fibrotic mass and effusion.


Assuntos
Artrite Reumatoide/tratamento farmacológico , Tamponamento Cardíaco/etiologia , Derrame Pericárdico/diagnóstico por imagem , Pericardite/patologia , Pericárdio/patologia , Anticorpos Monoclonais/uso terapêutico , Antirreumáticos/uso terapêutico , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/cirurgia , Ecocardiografia , Feminino , Fibrose , Humanos , Imagem Cinética por Ressonância Magnética , Pessoa de Meia-Idade , Derrame Pericárdico/cirurgia , Pericardiectomia , Pericardite/cirurgia , Pericárdio/cirurgia , Fator de Necrose Tumoral alfa/antagonistas & inibidores
15.
J Vet Cardiol ; 23: 32-37, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31174727

RESUMO

A 4-year-old crossbreed dog presented with a two-day history of lethargy and abdominal effusion. Physical examination and echocardiography revealed pericardial effusion with cardiac tamponade. Pericardiocentesis was performed. Intracytoplasmic Leishmania amastigotes were found on cytological examination of the pericardial fluid. The animal was treated with N-methylglucamine antimoniate and allopurinol. After an initial favorable response, cardiac tamponade reoccurred one month later. The dog died during a pericardiectomy four months after the initial diagnosis. Histology confirmed the presence of chronic pericarditis. The presence of Leishmania amastigotes on cytological examination of pericardial effusion suggests a possible association between canine leishmaniasis and chronic pericarditis. This finding also supports the importance of cytological examination of pericardial fluid in areas endemic for canine leishmaniasis.


Assuntos
Doenças do Cão/parasitologia , Leishmaniose/veterinária , Derrame Pericárdico/veterinária , Alopurinol/uso terapêutico , Animais , Antiprotozoários/uso terapêutico , Tamponamento Cardíaco/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/fisiopatologia , Cães , Ecocardiografia/veterinária , Leishmania/isolamento & purificação , Leishmaniose/complicações , Leishmaniose/tratamento farmacológico , Antimoniato de Meglumina/uso terapêutico , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/parasitologia , Líquido Pericárdico/parasitologia
16.
J Vet Cardiol ; 23: 81-87, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31174732

RESUMO

An adult Jack Russel terrier dog presented for evaluation of large-volume peritoneal and pleural effusion. Echocardiography revealed scant pericardial effusion and abnormally thickened pericardium. Electrocardiography revealed complete atrioventricular block with junctional and ventricular escape beats and occasional ventricular premature complexes. Computed tomography of the thorax confirmed diffuse abnormal thickening of the pericardium, and a tentative diagnosis of constrictive-effusive pericarditis was made. The dog underwent subtotal pericardiectomy to remove the parietal pericardium and permanent epicardial pacemaker implantation to manage bradycardia. Based on pericardial histopathology and immunohistochemistry, a diagnosis of pericardial hemangiosarcoma was made. Systemic chemotherapy was initiated with doxorubicin 1 month after surgery. Despite initial improvement with chemotherapy, the dog was euthanized 4 months after surgery because of development of recurrent pleural effusion. To the author's knowledge, this is the first case report in dogs to describe isolated pericardial location of hemangiosarcoma resulting in constrictive-effusive pericarditis.


Assuntos
Doenças do Cão/diagnóstico por imagem , Doenças do Cão/patologia , Neoplasias Cardíacas/veterinária , Hemangiossarcoma/veterinária , Derrame Pericárdico/veterinária , Animais , Antibióticos Antineoplásicos/uso terapêutico , Doenças do Cão/terapia , Cães , Doxorrubicina/uso terapêutico , Ecocardiografia/veterinária , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/tratamento farmacológico , Hemangiossarcoma/diagnóstico por imagem , Hemangiossarcoma/tratamento farmacológico , Marca-Passo Artificial/veterinária , Derrame Pericárdico/diagnóstico por imagem , Pericardiectomia/veterinária , Pericardite Constritiva/veterinária , Pericárdio/patologia , Tomografia Computadorizada por Raios X/veterinária
17.
BMJ Case Rep ; 12(5)2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31118169

RESUMO

A 46-year-old man was admitted to the emergency department with fever and pleuritic thoracic pain. Six weeks prior to admission, the patient had undergone cardiac surgery. The ECG showed diffuse ST segment elevation and PR segment depression. The blood tests revealed increased inflammatory markers and negative myocardial necrosis markers. Pericardial and left-sided pleural effusion were noted. Sterile blood cultures were negative. Hence, the hypothesis of Dressler's syndrome was established. The patient improved clinically and analytically with a short course of anti-inflammatory therapy and was discharged with colchicine and acetylsalicylic acid. A thoracic radiography performed 2 months after showed complete remission of pleural effusion.


Assuntos
Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/fisiopatologia , Derrame Pericárdico/etiologia , Assistência ao Convalescente , Anemia Hemolítica Autoimune/sangue , Anemia Hemolítica Autoimune/tratamento farmacológico , Anti-Inflamatórios/uso terapêutico , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/metabolismo , Derrame Pericárdico/diagnóstico por imagem , Pericardite/diagnóstico por imagem , Pericardite/etiologia , Resultado do Tratamento
18.
Ann Thorac Cardiovasc Surg ; 25(3): 158-163, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31068506

RESUMO

PURPOSE: In the treatment of the postsurgical pericardial effusions via pericardiocentesis, determination of the puncture site might be difficult. Contrast echocardiography may not be efficient due to surgical artefacts and pulmonary problems and therefore may lead to inaccurate evaluation. Alternative imaging methods might be helpful to perform the pericardiocentesis with decreased complications. METHODS: We retrospectively analyzed the patients who had undergone pericardiocentesis in our department from January 2008 through April 2018. The procedure was performed in slightly semi-seated position with the guidance of the echocardiography and fluoroscopy. Following the catheterization, percutaneous drainage was performed. RESULTS: There were 63 patients needed intervention due to pericardial effusion. 67% of the patients were using warfarin and the next patients were using acetyl salicylic acid and/or clopidogrel. All effusions were in the posterolateral localization. The mean volume of aspirated pericardial fluid was 404 ± 173 mL (150-980 mL). Control echocardiograms showed that almost all fluid was drained in all patients and there were no procedural or follow-up complications. CONCLUSION: In the treatment of postoperative pericardial effusion, fluoroscopy is an alternative method to locate the catheter accurately in challenging situations following cardiac surgery. Thus, procedural risk minimizes and drainage of pericardial fluid is performed safely.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Derrame Pericárdico/cirurgia , Pericardiocentese , Radiografia Intervencionista , Cateterismo Cardíaco , Ecocardiografia , Fluoroscopia , Humanos , Posicionamento do Paciente , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Pericardiocentese/efeitos adversos , Pericardiocentese/métodos , Radiografia Intervencionista/efeitos adversos , Radiografia Intervencionista/métodos , Estudos Retrospectivos , Postura Sentada , Fatores de Tempo , Resultado do Tratamento
19.
BMJ Case Rep ; 12(5)2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31076489

RESUMO

A 47-year-old Malay man who presented with fever, poor oral intake and loss of weight for 1 month duration. Further work-up revealed evidence of disseminated Salmonella infection that was further complicated with pericardial and pleural empyema. Cultures from pericardial and pleural fluids grew Salmonella species with negative serial blood cultures. Contrast enhanced CT thorax showed pleural effusion with large pericardial effusion. The patient was treated with antibiotics and drainage of pericardial and pleural empyema was done and he was discharged well.


Assuntos
Antibacterianos/uso terapêutico , Febre/microbiologia , Derrame Pericárdico/microbiologia , Derrame Pleural/microbiologia , Infecções por Salmonella/diagnóstico , Salmonella/patogenicidade , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/fisiopatologia , Derrame Pericárdico/terapia , Derrame Pleural/fisiopatologia , Derrame Pleural/terapia , Infecções por Salmonella/tratamento farmacológico , Infecções por Salmonella/fisiopatologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Perda de Peso
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