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1.
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
2.
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
3.
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
4.
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
5.
A A Pract ; 13(4): 140-144, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31021824

RESUMO

Giant ovarian cystadenoma is a rare and often late presentation. The mass effect of such tumors can lead to profound respiratory and cardiovascular compromise, predominately through inferior vena cava compression, but also restriction of normal lung function through transdiaphragmatic mass effect and, as is seen in this case, cardiac tamponade. In this article, the authors outline an expedited program of preoperative optimization and a choreographed physiological assessment strategy to functionally assess the hemodynamic consequences of a giant ovarian mucinous neoplasm, thereby informing the safe conduct of anesthesia and surgery.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Cistadenoma Mucinoso/diagnóstico , Neoplasias Ovarianas/diagnóstico , Cuidados Pré-Operatórios/métodos , Tamponamento Cardíaco/etiologia , Cistadenoma Mucinoso/complicações , Cistadenoma Mucinoso/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Monitorização Fisiológica , Avaliação Nutricional , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/cirurgia , Tomografia Computadorizada por Raios X
7.
Curr Cardiol Rep ; 21(5): 41, 2019 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-30993456

RESUMO

PURPOSE OF REVIEW: The diagnosis of pericardial syndromes, while occasionally straightforward, includes a wide range of pathologies and is often a well-recognized clinical challenge. The aim of this review is to highlight the key role of the various imaging modalities for the diagnosis and management of the spectrum of pericardial diseases. RECENT FINDINGS: Cardiac imaging has become an integral part of the diagnostic process often beginning with echocardiography and supported by advanced imaging modalities including computed tomography, magnetic resonance imaging, and positive emission tomography. These modalities go beyond the simple identification of the pericardium, to identifying increased pericardial thickness, active pericardial edema and inflammation, and its effect on cardiac hemodynamics. Multimodality imaging has significantly facilitated the diagnosis and long-term management of patients with pericardial diseases. The role of these imaging modalities in overall prognosis and prevention remains to be investigated.


Assuntos
Cardiopatias/diagnóstico por imagem , Imagem Multimodal/métodos , Pericárdio/diagnóstico por imagem , Tamponamento Cardíaco/diagnóstico por imagem , Ecocardiografia , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias/congênito , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Cisto Mediastínico/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Pericardite/diagnóstico por imagem , Pericárdio/anormalidades , Tomografia Computadorizada por Raios X
8.
Cardiovasc Pathol ; 40: 41-46, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30852296

RESUMO

A rare case of extramedullary multiple myeloma causing cardiac tamponade secondary to a plasma cell-based pericardial effusion is described. A systematic search using PubMed (National Library of Medicine) was used to identify a further 27 cases dating back to 1970. Case characteristics, treatment strategies, and survival time following tamponade are discussed. Linear regression demonstrated a weak but statistically significant correlation between survival time following tamponade and treatment with systemic chemotherapy and steroids (ß=16.8 weeks, P=.009). However, this manifestation of extramedullary multiple myeloma still conveys a dismal prognosis with a median survival following tamponade of only 6 weeks based on our review.


Assuntos
Tamponamento Cardíaco/etiologia , Mieloma Múltiplo/complicações , Derrame Pericárdico/etiologia , Plasmócitos/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/cirurgia , Ecocardiografia , Evolução Fatal , Feminino , Humanos , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/patologia , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/cirurgia , Pericardiocentese , Plasmócitos/efeitos dos fármacos , Fatores de Risco , Resultado do Tratamento
9.
Thromb Haemost ; 119(4): 512-514, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30743273

RESUMO

Superior vena cava (SVC) cancerous thrombosis is extremely sparse, especially in the setting of extrathoracic tumours. Herein, we present the case of a patient with a squamous cell carcinoma of the tongue, who presented with SVC syndrome possibly secondary to symptomatic metastatic pericardial effusion. In this unique patient, the disastrous concurrence of all the elements of Virchow's triad within the confined anatomical space of SVC may have precipitated extensive vessel thrombosis with catastrophic consequences. To our knowledge, there has been no previous report about presence of SVC cancerous thrombosis in squamous cell tongue cancer. In this respect, our report may provide an unusual mechanism of tongue cancer expansion, which clinicians should be familiar with. In addition, it may highlight the clinical importance of SVC thrombosis on patients' clinical outcome, as well as the role of transoesophageal echocardiography in early detection of occult thrombi in the sub-set of patients with SVC syndrome.


Assuntos
Carcinoma de Células Escamosas/patologia , Síndrome da Veia Cava Superior/diagnóstico por imagem , Síndrome da Veia Cava Superior/etiologia , Trombose/etiologia , Neoplasias da Língua/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico por imagem , Tamponamento Cardíaco/diagnóstico por imagem , Ecocardiografia , Ecocardiografia Transesofagiana , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Trombose/diagnóstico por imagem , Neoplasias da Língua/complicações , Neoplasias da Língua/diagnóstico por imagem , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/fisiopatologia
10.
Catheter Cardiovasc Interv ; 93(1): E56-E62, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30244510

RESUMO

BACKGROUND: Iatrogenic hemorrhagic pericardial tamponade (IHPT) represents a life-threating condition requiring emergency pericardiocentesis. In this clinical context, reinfusion of pericardial blood can stabilize the patient and sustain hemodynamic conditions. AIMS AND METHODS: We reviewed all cases of IHPT occurred at our hospital over a 10 years span. In all patient autologous blood reinfusion through a femoral vein was performed. RESULTS: In our clinical experience of 30 consecutive patients with hemorrhagic cardiac tamponade, this technique was successful to limit blood transfusions, to prevent further clinical worsening and bridge patients with intractable bleeding, to cardiac surgery. No major adverse reactions were directly related to blood autotransfusion. CONCLUSION: In the complex clinical scenario of acute tamponade occurring during catheter-based cardiac procedures, autotransfusion of pericardial blood through a femoral vein is safe and effective. It can be a useful trick up the sleeve of the interventional cardiologist.


Assuntos
Transfusão de Sangue Autóloga , Cateterismo Cardíaco/efeitos adversos , Tamponamento Cardíaco/terapia , Veia Femoral , Hemorragia/terapia , Doença Iatrogênica , Pericardiocentese , Idoso , Idoso de 80 Anos ou mais , Transfusão de Sangue Autóloga/efeitos adversos , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Estudos de Viabilidade , Feminino , Hemorragia/diagnóstico por imagem , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pericardiocentese/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
12.
Ann Thorac Surg ; 107(1): e27-e29, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29932888

RESUMO

A 58-year-old man presented with tamponade and underwent an emergency pericardiocentesis. We made the diagnosis of methicillin-resistant Staphylococcus aureus pericarditis based on culture results and treated the patient with pericardial drainage and antibiotics as the first-line therapy. After temporary relief, reaccumulation of effusion developed. We successfully created a pericardial window using thoracotomy, and the patient's postoperative course was uneventful. Methicillin-resistant Staphylococcus aureus pericarditis is an extremely rare and life-threatening illness. No consensus exists concerning the ideal surgical intervention. Creating a pericardial window using thoracotomy can be an effective definitive therapy for methicillin-resistant Staphylococcus aureus pericarditis, especially for patients with significant pericardial adhesions.


Assuntos
Tamponamento Cardíaco/etiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Técnicas de Janela Pericárdica , Pericardite/cirurgia , Infecções Estafilocócicas/cirurgia , Antibacterianos/uso terapêutico , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/cirurgia , Terapia Combinada , Quimioterapia Combinada , Ecocardiografia , Emergências , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Líquido Pericárdico/microbiologia , Pericardiocentese , Pericardite/complicações , Pericardite/tratamento farmacológico , Pericardite/microbiologia , Diálise Renal , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Tomografia Computadorizada por Raios X , Dispositivos de Acesso Vascular/efeitos adversos
13.
Eur J Cardiothorac Surg ; 55(2): 369-370, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29939241

RESUMO

A 23-year-old man, diagnosed with Wolff-Parkinson-White syndrome and who had undergone several catheter ablations, presented 2 months after the most recent ablation with cardiac tamponade following physical exertion. Emergency surgery revealed a perforation between the inferior vena cava and the right atrium. This perforation was repaired with a bovine pericardium patch. To our knowledge, this is the first case of delayed cardiac tamponade after catheter ablation due to a Valsalva manoeuvre (such as weightlifting) in a patient with a normal international normalized ratio and normal platelet count.


Assuntos
Tamponamento Cardíaco , Ablação por Cateter/efeitos adversos , Manobra de Valsalva , Adulto , Procedimentos Cirúrgicos Cardíacos , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/cirurgia , Humanos , Masculino , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Derrame Pericárdico/cirurgia , Síndrome de Wolff-Parkinson-White/cirurgia , Adulto Jovem
14.
Eur Heart J Cardiovasc Imaging ; 20(3): 298-306, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29982372

RESUMO

AIMS: To review 2D and Doppler findings in patients diagnosed with effusive-constrictive pericarditis (ECP) and compare these to patients with cardiac tamponade and patients with surgically-proven constrictive pericarditis (CP). METHODS AND RESULTS: We identified 22 patients diagnosed with ECP at Mayo Clinic, MN, USA between 2002 and 2016 who had persistent elevation of jugular venous pressure post-pericardiocentesis. We compared them to 30 patients with CP and 30 patients with cardiac tamponade who had normalization of venous pressure post-pericardiocentesis. All patients were in sinus rhythm. Mean age was 57 ± 18 years in the ECP group; 36% were females. Most ECP and cardiac tamponade cases were idiopathic (41% and 33%, respectively). Prior to pericardiocentesis, medial and lateral e' velocities were higher in ECP compared with tamponade; both ECP and tamponade patients had markedly decreased hepatic vein diastolic forward flow velocities. Inspiratory and expiratory mitral E/A ratios were higher in ECP compared with tamponade, but lower than those observed in CP. Post-pericardiocentesis, hepatic vein diastolic forward flow velocities increased in both ECP and tamponade. Hepatic vein diastolic reversal velocities decreased in tamponade but were unchanged in ECP. During median follow-up of 481 days, three patients required pericardiectomy for CP; they were all in the ECP group (14% of ECP cases). CONCLUSION: ECP may have unique echo-Doppler features that distinguish it from both CP and tamponade. Our findings suggest that ECP could be diagnosed by echocardiography even prior to pericardiocentesis. ECP appears to have a good prognosis, particularly in patients presenting acutely.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/cirurgia , Ecocardiografia Doppler/métodos , Pericardite Constritiva/diagnóstico por imagem , Pericardite Constritiva/cirurgia , Centros Médicos Acadêmicos , Idoso , Tamponamento Cardíaco/fisiopatologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericardiectomia/métodos , Pericardiocentese/métodos , Pericardite Constritiva/fisiopatologia , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios , Prognóstico , Estudos Retrospectivos , Medição de Risco , Estatísticas não Paramétricas , Resultado do Tratamento
15.
Am J Emerg Med ; 37(1): 175.e3-175.e5, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30361149

RESUMO

Ventricular pseudoaneurysm rupture is a rare finding in emergency departments in the era of percutaneous coronary intervention. It is an infrequent complication after acute myocardial infarction. We present a case of ventricular pseudoaneurysm rupture and examine current literature on the pathophysiology and imaging guidelines on the topic. The patient is a 58-year-old male that presented to the emergency department with dizziness and syncope. Imaging in the emergency department included computed tomography of the chest and an ultrasound that showed pseudoaneurysm with hemopericardium and early cardiac tamponade. He was treated surgically. Ventricular pseudoaneurysm rupture is an uncommon finding in medicine and the emergency department. Point-of-care ultrasound is an important diagnostic modality to identify this critical complication and prompt surgical management.


Assuntos
Falso Aneurisma/diagnóstico por imagem , Tontura/etiologia , Ventrículos do Coração/diagnóstico por imagem , Síncope/etiologia , Falso Aneurisma/complicações , Falso Aneurisma/fisiopatologia , Falso Aneurisma/cirurgia , Tamponamento Cardíaco/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Serviço Hospitalar de Emergência , Ventrículos do Coração/fisiopatologia , Ventrículos do Coração/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Derrame Pericárdico/diagnóstico por imagem , Testes Imediatos , Ruptura/complicações , Ruptura/diagnóstico por imagem , Ruptura/cirurgia , Ultrassonografia Doppler
16.
Emerg Radiol ; 26(5): 587-589, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28616788

RESUMO

This is the 39th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at http://www.erad.org/page/CCIP_TOC .


Assuntos
Aneurisma Dissecante/complicações , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
17.
Am J Emerg Med ; 37(2): 321-326, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30471929

RESUMO

BACKGROUND: Pericardial tamponade is neither a clinical nor an echocardiographic diagnosis alone. The echocardiogram carries diagnostic value and should be performed when there is suspicion for tamponade based on the history and physical exam. A pericardial effusion uncovered on point-of-care ultrasound (POCUS) may be mistaken for tamponade and thereby lead to inappropriate and invasive management with pericardiocentesis. OBJECTIVE: This narrative review will summarize the echocardiographic findings and associated pathophysiology that support the diagnosis of pericardial tamponade. It will provide a succinct description of the core findings for which emergency physicians should evaluate at the bedside, along with potential pearls and pitfalls in this evaluation. Labeled images and video clips are included. DISCUSSION: The core echocardiographic findings of pericardial tamponade consist of: a pericardial effusion, diastolic right ventricular collapse (high specificity), systolic right atrial collapse (earliest sign), a plethoric inferior vena cava with minimal respiratory variation (high sensitivity), and exaggerated respiratory cycle changes in mitral and tricuspid valve in-flow velocities as a surrogate for pulsus paradoxus. CONCLUSION: The emergency physician must recognize and understand the core echocardiographic findings and associated pathophysiology that suggest pericardial tamponade. Together with the history and clinical exam, these findings can help make the overall diagnosis and determine management.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Ecocardiografia , Derrame Pericárdico/complicações , Átrios do Coração/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Humanos , Sistemas Automatizados de Assistência Junto ao Leito
20.
Can J Cardiol ; 34(12): 1688.e21-1688.e23, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30527167

RESUMO

Diaphragmatic eventration in old age is a rare phenomenon. Typically, it is thought to originate as a result of failure of development of the muscles of the diaphragm. Less commonly, it can occur secondary to acquired conditions resulting from spinal cord or phrenic nerve injury and is only detected incidentally when the patient presents with dyspnea, chest infection, or cardiac compression symptoms. Herein, we report a case of right diaphragmatic paralysis in a 58-year-old man with a presentation of marked elevation of the right hemidiaphragm and ascites causing a picture compatible with cardiac tamponade.


Assuntos
Tamponamento Cardíaco/etiologia , Eventração Diafragmática/complicações , Paralisia Respiratória/complicações , Ascite/diagnóstico por imagem , Tamponamento Cardíaco/diagnóstico por imagem , Eventração Diafragmática/diagnóstico por imagem , Ecocardiografia Transesofagiana , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
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