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3.
Kyobu Geka ; 72(10): 744-748, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582688

RESUMO

Peicardiocentesis and surgical pericardial drainage are essential treatment and diagnostic modality for pericardial effusion. Though it theoretically is a simple therapeutic method, accurate diagnosis, correct decision, and safe procedure are not always easy. Thoracic and cardiovascular surgeons are required to have high level of expertise in pericardial drainage as surgeons who specialize this anatomical part of the body. The presence of pericardial effusion does not always require drainage. Accurate diagnosis is essential to determine correct indication. Echocardiography and computed tomography are useful tools for accurate diagnosis. The percutaneous drainage has become much safer in these 2 decades with the aid of imaging technology, especially echocardiography and fluoroscopy. Surgical pericardial window still has its role and is considered one of the standard treatment methods with minimal chance to require repeat procedure compared to percutaneous drainage.


Assuntos
Tamponamento Cardíaco , Derrame Pericárdico , Pericardiocentese , Drenagem , Humanos , Paracentese , Estudos Retrospectivos
4.
Heart Surg Forum ; 22(5): E331-E339, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31596707

RESUMO

BACKGROUND: Although the use of transcatheter aortic valve replacement (TAVR) has recently become an attractive strategy in prohibitive surgical high-risk patients undergoing aortic valve replacement (AVR), the most appropriate treatment option in patients with an intermediate- to high-risk profile- whether conventional surgery (SAVR) or TAVR-has been widely debated. METHODS: One hundred and forty-three consecutive patients with intermediate to high risk were prospectively enrolled and selected to undergo SAVR (Group 1 [G1], n = 63) or TAVR (Group 2 [G2], n = 80) following a multidisciplinary evaluation including frailty, anatomy, and degree of atherosclerotic disease of the aorta/peripheral vessels. The mean logistic EuroSCORE (G1 = 20.11 ± 7.144 versus G2 = 23.33 ± 8.97; P = .022), STS score (G1 = 5.722 ± 1.309 versus G2 = 5.958 ± 1.689; P = .347), and preoperative demographics such as sex, left ventricular ejection fraction (LVEF),  body mass index (BMI), peripheral vascular disease, diabetes, atrial fibrillation, renal impairment and syncope were similar. Of note, chronic obstructive pulmonary disease was more frequent in TAVR patients (G2 [46.2%] versus G1 [19.0%]; P = .001), whereas pulmonary hypertension was more frequent in SAVR group (G1 [47.6%] versus G2 [17.5%]; P = .000). The SAVR was performed with either a mechanical or tissue valve; meanwhile, TAVR was performed with either Core valve prosthesis or Edwards-Sapiens XT valve. RESULTS: SAVR group showed higher incidence of some postoperative complications compared to TAVR, namely, postoperative bleeding (4.8% versus 0.0%; P = .048), tamponade (4.8% versus 0.0%; P = .048) and postoperative atrial fibrillation (34.9% versus 10.0%; P = .000), whereas TAVR group had a higher incidence of other sets of postoperative complications, namely, left bundle branch block (58.8% versus 4.8%; P = .000), need for permanent pacemaker implantation (25.0% versus 1.6%; P = .000) and peripheral vascular complications (15.0% versus 0.0%; P = .001). On the contrary, when the two groups were compared they did not show any significant difference regarding anemia requiring more than two units of blood transfusion, postoperative renal failure, stroke, myocardial infarction, and hospital mortality. P = .534, .873, .258, .373 and .072 respectively. Hospital mortality was similar among the two groups (G1 = 0% versus G2 = 5%; P = .072). At the 24-month follow-up, overall mortality, major adverse cardiac and cerebrovascular events were comparable between the two groups but prosthetic regurgitation was better in SAVR group (G2 = 8 patients [10.0%] versus G1 = 1 patient [1.6%] in SAVR group; P = .040). CONCLUSION: In this study, we could not detect an advantage in survival when SAVR or TAVR were utilized in intermediate to high surgical risk patients needing aortic valve replacement for severe aortic stenosis.


Assuntos
Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Complicações Pós-Operatórias/etiologia , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/etiologia , Bloqueio de Ramo/etiologia , Tamponamento Cardíaco/etiologia , Feminino , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/mortalidade , Mortalidade Hospitalar , Humanos , Hipertensão Pulmonar/complicações , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Hemorragia Pós-Operatória/etiologia , Desenho de Prótese , Doença Pulmonar Obstrutiva Crônica/complicações , Estudos Retrospectivos , Acidente Vascular Cerebral/etiologia , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Substituição da Valva Aórtica Transcateter/mortalidade , Resultado do Tratamento
6.
Metas enferm ; 22(8): 5-12, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184993

RESUMO

Objetivo: describir el grado de conocimiento en maniobras de soporte vital básico (SVB) de los árbitros de fútbol del Principado de Asturias. Metodología: estudio descriptivo transversal. Se diseñó un cuestionario de 20 preguntas dividido en cuatro áreas: reanimación cardiopulmonar y compresiones torácicas, ventilación, uso del desfibrilador automático (DEA) y desobstrucción de la vía aérea. Se distribuyó por correo electrónico a los 412 árbitros censados en el Comité Técnico de Árbitros del Principado de Asturias. Se realizó análisis descriptivo usando el paquete estadístico SPSS versión 23.0. Resultados: participaron 186 sujetos, el 45,25% del total de árbitros censados: 176 hombres (94,6%) y 10 mujeres (5,4%), con una edad media (desviación estándar) de 24,78 (6,98) años. Los árbitros cuentan con una media (DE) de tiempo arbitral de 6,02 (5,78) años. El 87,63% (n= 163) no tiene una profesión relacionada con el deporte ni con la sanidad. El 65,6% (n= 122) no ha recibido formación en SVB, solo el 51,07% (n= 95) obtuvo una puntuación mayor o igual a 10 respuestas correctas. El porcentaje de respuestas correctas a las cuestiones sobre reanimación cardiopulmonar fue del 49,28%, sobre ventilación fue del 76,66%, 39,71% en el bloque relacionado con el DEA y un 41% en desobstrucción de la vía aérea. Se detectaron diferencias estadísticamente significativas (p< 0,05) en el grado de conocimientos relacionado con la edad, la profesión y la formación previa en SVB. Conclusiones: los árbitros del Principado de Asturias poseen un nivel de conocimiento medio-bajo en SVB. Los que han mostrado mayor nivel de conocimientos son aquellos con profesiones relacionadas con la sanidad y el deporte, con formación previa en SVB y con edades comprendidas entre 20-40 años


Objectives: to describe the level of knowledge regarding basic life support (BLS) maneuvers by football referees from the Principality of Asturias. Methodology: a descriptive cross-sectional study. A 20-item questionnaire was designed, split into four areas: cardiopulmonary resuscitation and chest compressions, ventilation, use of automatic defibrillator (AED), and airway clearance. This questionnaire was sent by email to the 412 referees registered in the Technical Committee of Referees of the Principality of Asturias. Descriptive analysis was conducted, using the SPSS statistical package version 23.0. Results: the study included 186 subjects, 45.25% of the referees registered in the census: 176 men (94.6%) and 10 women (5.4%), with a mean age (standard deviation) of 24.78 (6.98) years. These referees had a mean (SD) referee time of 6.02 (5.78) years; the profession of 87.63% (n= 163) of them was not associated with sports or healthcare, while 65.6% (n= 122) had received no training in BLS. Only 51.07% (n= 95) reached a score equal to or above 10 correct answers. The percentage of correct answers to questions about cardiopulmonary resuscitation was 49.28%, about ventilation: 76.66%, in the block dealing with AED: 39.71%, and 41% in airway clearance. Statistically significant differences (p< 0.05) were detected in the level of knowledge in association with age, profession, and previous training in BLS. Conclusions: referees in the Principality of Asturias had medium-low knowledge about BLS. Those who showed a higher level of knowledge were those with professions associated with healthcare and sports, previous training in BLS, and ages in the 20-to-40-year range


Assuntos
Humanos , Masculino , Feminino , Adulto , Reanimação Cardiopulmonar , Tamponamento Cardíaco , Cardioversão Elétrica , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Inquéritos e Questionários
7.
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
8.
BMJ Case Rep ; 12(9)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31492729

RESUMO

Primary cardiac tumours are relatively rare in the paediatric population, with benign tumours accounting for >90% of cases. Cardiac fibromas are rare primary tumours that typically reside in the ventricles. Symptoms are usually the result of blood outflow obstruction or disruption of the cardiac conduction system. They do not typically regress and usually require surgical intervention. In this case, we report a rare finding of a right atrial fibroma in an 18-month-old female who presented with lethargy and vomiting. Chest X-ray revealed an enlarged cardiac silhouette, and follow-up CT showed a 3.7×3.2×3.7 cm hypodense lesion in the right atrium. Cardiac MRI revealed the diagnosis, which was confirmed on pathology.


Assuntos
Fibroma/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Apêndice Atrial/diagnóstico por imagem , Apêndice Atrial/cirurgia , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/terapia , Ecocardiografia , Feminino , Fibroma/complicações , Fibroma/cirurgia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/cirurgia , Humanos , Imagem Tridimensional , Lactente , Imagem por Ressonância Magnética , Derrame Pericárdico/etiologia , Derrame Pericárdico/terapia , Pericardiocentese , Síndrome do Desconforto Respiratório do Adulto/etiologia , Tomografia Computadorizada por Raios X , Vômito/etiologia
10.
Am J Case Rep ; 20: 1155-1158, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31387984

RESUMO

BACKGROUND Ventricular rupture is a complication of acute myocardial infarction (AMI) that results in hemopericardium and cardiac tamponade and has a high mortality rate. Most cases involve the left ventricular free wall, and there have been few previous reports of solitary right ventricular free wall rupture. This report is of a case of fatal right ventricular free wall rupture during percutaneous coronary intervention (PCI) for inferior acute myocardial infarction (AMI). CASE REPORT A 76-year-old woman underwent emergency coronary angiography following inferior AMI. During angiography and attempted percutaneous coronary intervention (PCI), sudden onset of cardiac arrest occurred due to cardiac tamponade. Blood was drained from the pericardium by pericardiocentesis. Despite of advanced cardiac support, the patient died. The post mortem findings showed a solitary right ventricular free wall rupture due to inferior myocardial infarction. CONCLUSIONS A rare case is presented of right ventricular free wall rupture following AMI that occurred during PCI. This case demonstrates that early diagnosis and management are required to prevent patient mortality.


Assuntos
Tamponamento Cardíaco/etiologia , Ruptura Cardíaca Pós-Infarto/etiologia , Ventrículos do Coração/lesões , Infarto Miocárdico de Parede Inferior/cirurgia , Intervenção Coronária Percutânea/efeitos adversos , Idoso , Evolução Fatal , Feminino , Humanos
12.
BMJ Case Rep ; 12(7)2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31289165

RESUMO

Cowden syndrome (CS) is a rare disorder characterised by multiple non-cancerous, tumour-like growths called hamartomas. The syndrome is associated with the development of cancer of the breast, endometrium, kidneys, skin and rarely the brain. We report a rare case of symptomatic cardiac haemangioma in a patient with CS. A 54-year-old woman with CS presented with dyspnoea and orthopnoea in the setting of cardiac tamponade. Echocardiography revealed a large haemopericardium and tamponade physiology, secondary to a pericardial mass. The patient underwent urgent cardiopulmonary bypass with removal of the mass. Histopathology confirmed a benign cavernous haemangioma. We postulate that tumours involving the heart/pericardium may be an additional manifestation of CS. This case further highlights the necessity to consider pericardial/cardiac manifestations in patients with hamartomatous syndromes who present with cardiorespiratory symptoms, so that opportunistic investigation and treatment may be instituted.


Assuntos
Tamponamento Cardíaco/etiologia , Síndrome do Hamartoma Múltiplo/complicações , Hemangioma Cavernoso/complicações , Hemangioma Cavernoso/cirurgia , Tamponamento Cardíaco/diagnóstico por imagem , Ponte Cardiopulmonar/métodos , Ecocardiografia/métodos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Neoplasias Cardíacas/patologia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
13.
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
14.
Rinsho Ketsueki ; 60(6): 577-581, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31281147

RESUMO

Cardiac involvement during lymphoma often causes complications, including arrhythmia. A 68-year-old male with cardiac tamponade was diagnosed with diffuse large B-cell lymphoma with cardiac involvement based on the presence of the tumor mass in the myocardium and lymphoma cells in the pericardial effusion. He developed atrial fibrillation, ventricular tachycardia, and atrial flutter after initiating chemotherapy. Following chemotherapy, sinus rhythm was restored without invasive treatment for arrhythmia, while the cardiac mass disappeared. No recurrent arrhythmias were observed. In lymphoma with cardiac involvement, unexpected arrhythmias can emerge after initiation of chemotherapy, which could potentially be related to accelerated cardiac remodeling owing to the rapid relief of cardiac damage. Follow-up using electrocardiogram is thus necessary during chemotherapy for cardiac lymphoma, despite the absence of arrhythmia at the time of diagnosis.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Tamponamento Cardíaco/induzido quimicamente , Neoplasias Cardíacas/complicações , Linfoma Difuso de Grandes Células B/complicações , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Arritmias Cardíacas , Neoplasias Cardíacas/tratamento farmacológico , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Derrame Pericárdico
15.
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
16.
J Card Surg ; 34(9): 829-836, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31269314

RESUMO

BACKGROUND AND AIMS: Pneumopericardium is a rare air leak syndrome caused by the abnormal presence of air in the pericardial sac, with a high risk of morbidity and mortality. It is clinically divided into nontension and tension pneumopericardium, with the latter resulting in a decreased cardiac output and circulatory failure. There are limited data regarding nontraumatic pneumopericardium in nonventilated pediatric patients. Therefore, we aimed to describe a case of tension pneumopericardium and review the available literature. METHODS: Case report and literature review of nontraumatic pneumopericardium in nonventilated pediatric patients. RESULTS: A 2-month-old infant developed cardiac tamponade secondary to tension pneumopericardium 11 days after cardiac surgery promptly resolved with pericardium drainage. We reviewed the literature on this topic and retrieved 50 cases, of which 72% were nontension whereas a minority were tension pneumopericardium (28%). Patients with tension pneumopericardium were mostly neonates (35.7% vs 22.2%), presented with an isolated air leak (64.3% vs 36.1%), and had a history of surgery (28.6% vs 8.3%) or hematological disease (28.6% vs 11.1%). In all nontension cases, treatment was conservative, whilst in all other cases, pericardiocentesis/pericardium drainage was carried out. There was a high survival rate (86.0%), which was lower in patients with tension pneumopericardium (71.4% vs 91.6%). CONCLUSIONS: Pneumopericardium is a rare condition with a higher mortality rate in patients with tension pneumopericardium, which requires immediate diagnosis and treatment. In nonventilated patients, tension pneumopericardium occurred more frequently in neonates, as an isolated air leak, and in those with a history of surgery or hematological disease.


Assuntos
Tamponamento Cardíaco/etiologia , Drenagem/métodos , Pneumopericárdio , Complicações Pós-Operatórias , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/mortalidade , Cardiopatias Congênitas/cirurgia , Humanos , Recém-Nascido , Masculino , Pneumopericárdio/complicações , Pneumopericárdio/diagnóstico , Pneumopericárdio/mortalidade , Respiração Artificial , Taxa de Sobrevida/tendências
17.
BMJ Case Rep ; 12(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31320372

RESUMO

Pericardial effusions resulting in a cardiac tamponade have previously been reported with oesophageal cancers. However, most of these cases have been reported in association with radiation and chemotherapy. Rarely as oesophageal pericardial fistuls (OPF) have been reported as the culprits in causing pericardial effusions in patients with oesophageal cancers. Here we present the case of a 61-year-old woman who presented clinically with cardiac tamponade. She was found to have an OPF due to oesophageal squamous cell cancer that resulted in a purulent pericardial effusion. She underwent a median sternotomy, pericardial decompression, and mediastinal debridement. An oesophageal stent was attempted unsuccessfully. The patient refused any more aggressive treatments and was discharged to a hospice where she passed away 13 days after presentation. This case and the associated literature review highlights an unusual presentation of oesophageal cancer and an uncommon cause of cardiac tamponade.


Assuntos
Tamponamento Cardíaco/etiologia , Fístula Esofágica/etiologia , Neoplasias Esofágicas/complicações , Carcinoma de Células Escamosas do Esôfago/complicações , Pericardite/etiologia , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Eletrocardiografia , Endoscopia do Sistema Digestório , Fístula Esofágica/diagnóstico , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/diagnóstico , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Mediastinite/complicações , Pessoa de Meia-Idade , Pericardite/diagnóstico , Pericardite/cirurgia , Supuração , Tomografia Computadorizada por Raios X
18.
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
19.
BMJ Case Rep ; 12(7)2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31352392

RESUMO

A 53-year-old female patient known to have Cowden disease (PTEN mutation positive) was found to have a mass at the left atrium on a CT coronary angiography performed as part of a preoperative workup for an unrelated surgery. Further radiological characterisation of the lesion was achieved using MRI and positron emission tomography. Interval growth prompted surgical excision; however, surgery was expedited after the patient presented with haemopericardium and cardiac tamponade. The patient was discharged home 8 days postoperatively, and no intraoperative or postoperative complications were encountered. A diagnosis of cavernous haemangioma was made on histology.


Assuntos
Tamponamento Cardíaco/complicações , Síndrome do Hamartoma Múltiplo , Átrios do Coração/patologia , Hemangioma Cavernoso/patologia , Achados Incidentais , Angiografia Coronária , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , PTEN Fosfo-Hidrolase , Tomografia Computadorizada por Raios X , Resultado do Tratamento
20.
J Vet Emerg Crit Care (San Antonio) ; 29(4): 413-417, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31228330

RESUMO

OBJECTIVE: To describe the use of pericardial catheters in dogs with pericardial effusion (PE), and detail any associated adverse events. DESIGN: Retrospective study. SETTING: University teaching hospital. ANIMALS: Eighteen client-owned dogs that had pericardial catheters placed for pericardial fluid drainage between May 2007 and January 2015. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All pericardial catheters were placed within 5 hours of presentation, usually within 1 hour (median 72.5 min, range 45-300 min). Ten of 18 cases were sedated with butorphanol, and 4 with additional midazolam. Four had pericardial catheters positioned for single drainage only and were immediately removed. The other 14 pericardial catheters remained in situ for a median of 18 hours (range 2-88 h). Ten of the remaining 14 cases were redrained after pericardial catheter placement. The main adverse events reported were new arrhythmias in 6/18 cases, with 4 of these 6 patients being administered anti-arrhythmic therapy. No infectious or functional complications were reported. Ten patients were discharged, 1 died and 7 were euthanized. CONCLUSIONS: Thoracic drainage catheters inserted into the pericardial space via a modified-Seldinger technique can be positioned in dogs to aid management of PEs. The main associated adverse event is arrhythmia. Minimal sedation is required for placement, and dogs tend not to require postprocedural analgesia. Catheters can remain in situ for repeated drainage, potentially decreasing staffing time requirement and repeat sedation. Their use is associated with a rate of arrhythmia requiring treatment of 22%, compared to that of needle pericardiocentesis alone at 13%. They are easy to position using equipment available in many facilities.


Assuntos
Cateteres Cardíacos/veterinária , Tamponamento Cardíaco/veterinária , Doenças do Cão/terapia , Drenagem/veterinária , Derrame Pericárdico/veterinária , Animais , Tamponamento Cardíaco/prevenção & controle , Cães , Feminino , Humanos , Masculino , Derrame Pericárdico/complicações , Derrame Pericárdico/terapia , Pericardiocentese/efeitos adversos , Pericárdio , Estudos Retrospectivos
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