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1.
Kyobu Geka ; 73(11): 955-957, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33130723

RESUMO

Pericardial effusion due to malignancy often needs drainage, however, it is difficult to repeat pericardiocentesis. We report a case of malignant pericardial effusion in a 55-year-old female, who had been diagnosed with sigmoid colon cancer and treated with surgical resection and chemotherapy 2 years before. She developed multiple organ metastasis and suffered from dyspnea due to increasing pericardial effusion. We performed pericardiocentesis repeatedly, but the pericardial effusion continuously increased. Therefore, we inserted a drainage catheter into the pericardial space, which was connected to a subcutaneously placed port system. She was discharged from the hospital, but expired 12 days later. In the case of malignant pericardial effusion, subcutaneous placing of a port system may be safe and useful.


Assuntos
Tamponamento Cardíaco , Neoplasias , Derrame Pericárdico , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/cirurgia , Drenagem , Feminino , Humanos , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Derrame Pericárdico/cirurgia , Pericardiocentese , Pericárdio
2.
J Comput Assist Tomogr ; 44(4): 599-604, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32697531

RESUMO

BACKGROUND: In cardiac tamponade, coronary sinus (CS) as an intrapericardial structure can be easily compressed, whereas inferior vena cava (IVC) dilates. This inverse relationship may augment their roles in the evaluation of tamponade imaging. AIM: We assessed the usefulness of computerized tomographic measures of CS diameter and also CS/IVC ratio to predict tamponade in clinically stable patients with large pericardial effusion. METHODS: Sixty-six clinically stable patients who had large pericardial effusions were included. Coronary sinus diameter was measured from the point at 1 cm proximal to the CS ostium. Inferior vena cava diameter was measured from the segment between its right atrial orifice and hepatic vein. RESULTS: Patients with tamponade had smaller CS diameter and CS/IVC ratio. After adjusting with other parameters, only either CS diameter or CS/IVC ratio predicted tamponade, respectively. (Nagelkerke r value for CS was 53.7% and 72.1% for CS/IVC ratio). In Receiver Operating Characteristic Curve analysis, a cutoff value of 6.85 mm for CS diameter had 82.6% sensitivity and 83.7% specificity and a cutoff value of 27% for CS/IVC ratio had 87.0% sensitivity and 86.0% specificity for predicting cardiac tamponade. CONCLUSIONS: The tomographic measures of both the CS diameter and the CS/IVC ratio predicted tamponade in clinically stable patients with large pericardial effusion. Compared with CS diameter, CS/IVC ratio seemed to be a more powerful predictor of tamponade.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Seio Coronário/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/patologia , Seio Coronário/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Veia Cava Inferior/patologia
3.
Clin Rheumatol ; 39(9): 2811-2815, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32720260

RESUMO

In the midst of the COVID-19 pandemic, further understanding of its complications points towards dysregulated immune response as a major component. Systemic lupus erythematosus (SLE) is also a disease of immune dysregulation leading to multisystem compromise. We present a case of new-onset SLE concomitantly with COVID-19 and development of antiphospholipid antibodies. An 18-year-old female that presented with hemodynamic collapse and respiratory failure, progressed to cardiac arrest, and had a pericardial tamponade drained. She then progressed to severe acute respiratory distress syndrome, severe ventricular dysfunction, and worsening renal function with proteinuria and hematuria. Further studies showed bilateral pleural effusions, positive antinuclear and antidouble-stranded DNA antibodies, lupus anticoagulant, and anticardiolipin B. C3 and C4 levels were low. SARS-Cov-2 PCR was positive after 2 negative tests. She also developed multiple deep venous thrombosis, in the setting of positive antiphospholipid antibodies and lupus anticoagulant. In terms of pathophysiology, COVID-19 is believed to cause a dysregulated cytokine response which could potentially be exacerbated by the shift in Th1 to Th2 response seen in SLE. Also, it is well documented that viral infections are an environmental factor that contributes to the development of autoimmunity; however, COVID-19 is a new entity, and it is not known if it could trigger autoimmune conditions. Additionally, it is possible that SARS-CoV-2, as it happens with other viruses, might lead to the formation of antiphospholipid antibodies, potentially contributing to the increased rates of thrombosis seen in COVID-19.


Assuntos
Síndrome Antifosfolipídica/imunologia , Infecções por Coronavirus/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Pneumonia Viral/imunologia , Adolescente , Anemia/etiologia , Anticorpos Anticardiolipina/imunologia , Anticorpos Antinucleares/imunologia , Anticorpos Monoclonais Humanizados/uso terapêutico , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/terapia , Anuria/etiologia , Betacoronavirus , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/terapia , Complemento C3/imunologia , Complemento C4/imunologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , DNA/imunologia , Ecocardiografia , Evolução Fatal , Feminino , Parada Cardíaca/etiologia , Hematúria/etiologia , Humanos , Inibidor de Coagulação do Lúpus/imunologia , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Pandemias , Posicionamento do Paciente , Pericardiocentese , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Decúbito Ventral , Proteinúria/etiologia , Diálise Renal , Insuficiência Renal/etiologia , Insuficiência Renal/terapia , Respiração Artificial , Síndrome do Desconforto Respiratório do Adulto/etiologia , Síndrome do Desconforto Respiratório do Adulto/terapia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Trombocitopenia/etiologia , Trombose Venosa/etiologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologia
6.
Medicine (Baltimore) ; 99(15): e19778, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282740

RESUMO

RATIONALE: Therapeutic or diagnostic thoracentesis is widely used in different clinical settings. Cardiac injury, a rare complication, could lead to fatal consequences. We describe a case of cardiac tamponade complicating thoracentesis that was recognized and rescued in a timely manner. PATIENT CONCERNS: A 42-year-old woman underwent blind thoracentesis due to excessive left pleural effusion after left pneumonectomy surgery. She suddenly lost consciousness and was in a state of shock a few minutes after needle insertion and fluid drainage. DIAGNOSIS: Bedside transthoracic echocardiography revealed pericardial effusion at a depth of 20 mm, and cardiac tamponade complicating thoracentesis was diagnosed. INTERVENTIONS: After draining 250 mL of non-coagulated blood by pericardiocentesis under transthoracic echocardiography guidance, a tube was placed for continuous drainage over the subsequent 36 hours. OUTCOMES: The patient's hemodynamic condition was stabilized hours after pericardiocentesis. The patient was discharged in good condition a few days later. LESSONS: Imaging assessment and guidance in the process of thoracentesis was indispensable, especially in a patient with altered intra-thoracic anatomy. Cardiac damage, as a life-threatening complication, should be considered once hemodynamic instability occurs during the procedure.


Assuntos
Tamponamento Cardíaco/etiologia , Pneumonectomia/métodos , Toracentese/efeitos adversos , Adulto , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/cirurgia , Drenagem/efeitos adversos , Ecocardiografia/métodos , Feminino , Humanos , Pericardiocentese/instrumentação , Derrame Pleural/cirurgia , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Resultado do Tratamento
7.
Ann Thorac Surg ; 110(4): 1357-1363, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32151579

RESUMO

BACKGROUND: Cardiac tamponade with acute aortic dissection type A can cause fatal outcomes. We previously reported excellent outcomes using percutaneous pericardial drainage with controlled volumes of aspirated pericardial effusion (controlled pericardial drainage [CPD]) to stabilize patients with critical cardiac tamponade. This study evaluates the early and late outcomes using this approach. METHODS: Between September 2003 and July 2018, 308 patients with acute aortic dissection type A were treated surgically, including 76 patients who presented with cardiac tamponade on hospital arrival. Forty-nine patients who did not respond to intravenous volume resuscitation underwent CPD in the emergency room, including 14 patients (28.6%) who presented with cardiopulmonary arrest. After CPD 39 patients (79.6%) were transferred to the operating room to undergo immediate aortic repair. The remaining 10 patients (20.4%) received medical treatment on arrival, followed by aortic repair within several days. RESULTS: In 49 patients the mean systolic blood pressure before CPD was 64.4 ± 10.3 mm Hg. Blood pressure rose significantly in all patients after CPD. The total volume of aspirated pericardial effusion was 46.8 ± 56.2 mL, and 30 of 49 patients (61%) required only 30 mL or less of aspiration to improve their blood pressure. All patients underwent successful aortic repair. Early hospital mortality was 16%. However there was no mortality related to CPD. The mean follow-up period was 52.9 ± 54.3 months. The cumulative survival rate was 63.4% after 5 years. CONCLUSIONS: CPD for critical cardiac tamponade with acute type A aortic dissection produced satisfactory early and late outcomes.


Assuntos
Aneurisma Dissecante/cirurgia , Aneurisma Aórtico/cirurgia , Tamponamento Cardíaco/cirurgia , Drenagem , Derrame Pericárdico/cirurgia , Idoso , Aneurisma Dissecante/complicações , Aneurisma Dissecante/mortalidade , Aneurisma Aórtico/complicações , Aneurisma Aórtico/mortalidade , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento
8.
Int J Cardiovasc Imaging ; 36(7): 1371-1376, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32221770

RESUMO

Delayed cardiac tamponade (DCT) can be a fatal complication after cardiac surgery, but its early diagnosis and/or prediction is sometimes difficult. This study aimed to confirm the efficacy of postoperative computed tomography (CT) as routine examination compared with transthoracic echocardiography (TTE) for predicting DCT after cardiac surgery. This study was a retrospective single-center analysis of 485 consecutive patients undergoing cardiac surgery from January 2016 to July 2018 in our department. Among them, 237 patients were enrolled in this analysis after application of the exclusion criteria: minimally invasive surgery via small thoracotomy, death in the acute phase, and no CT 7 ± 3 days after surgery. Pericardial effusion (PE) was measured at the thickest part using CT and TTE. DCT was found in nine enrolled patients (3.8%). The mean PE on CT was 7.7 ± 5.5 mm in the no event group and 23.4 ± 5.7 mm in the DCT group (p = 0.026), whereas the mean PE on TTE was 6.2 ± 4.5 mm in the no event group and 10.8 ± 4.4 mm in the DCT group (p = 0.170). On multivariate analysis, PE greater than 20 mm on CT (Odds ratio, 13.93; 95% confidence interval 2.57-75.46; p = 0.002) was a significant predictor of DCT. The present study suggested that postoperative CT examination is superior to TTE for predicting DCT. If PE is less than 20 mm on CT, it could be treated conservatively; otherwise, preventive/therapeutic intervention should be considered.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Tamponamento Cardíaco/diagnóstico por imagem , Ecocardiografia , Tomografia Computadorizada por Raios X , Idoso , Tamponamento Cardíaco/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
11.
Int J Cardiovasc Imaging ; 36(5): 947-969, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32048125

RESUMO

Pericardial abnormalities are common cardiovascular disease entity, which are encountered in various clinical settings. Imaging plays an integral role in evaluation of pericardial abnormalities. The appropriate use of multiple imaging modalities is crucial to initiate the diagnosis and guide the referring providers to establish a management plan. Echocardiography (echo) is the initial imaging modality of choice. Computed tomography (CT) and magnetic resonance imaging (MRI) are complementary imaging tools with better tissue characterization. Pericardial abnormalities include pericardial effusion, pericarditis, pericardial constriction, tamponade, pneumopericardium, pericardial rupture, fistulas, congenital abnormalities, and pericardial tumors. Pericardial effusion is a common clinical entity, where there is accumulation of fluid in the pericardial sac. Pericarditis can be acute, incessant, chronic, or recurrent. Pericardial thickening or enhancement are the main CT findings in acute pericarditis. Pericardial constriction results into diastolic heart failure. Differentiating constrictive pericarditis from restrictive cardiomyopathy is important, since these conditions can present with similar clinical and hemodynamic findings and both have different management. Right atrial or right ventricular compression by the pericardial sac contents should raise the suspicion for tamponade. Immediate pericardiocentesis to release the elevated intra-pericardial pressure can be lifesaving. Pericardial rupture is a serious condition that can occur after trauma and can lead to cardiac herniation. The main purpose of this article is to do a comprehensive review of the imaging appearance of pericardial diseases on different imaging modalities and establish a structured diagnostic approach for pericardial diseases to appropriately guide management.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Imagem Multimodal , Derrame Pericárdico/diagnóstico por imagem , Pericardite/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Pneumopericárdio/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Ecocardiografia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pericardite Constritiva/diagnóstico por imagem , Valor Preditivo dos Testes , Tomografia Computadorizada de Emissão , Tomografia Computadorizada por Raios X , Adulto Jovem
12.
Respir Med ; 163: 105879, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32056834

RESUMO

INTRODUCTION: Pericardial involvement of sarcoidosis is a rare cause for acute heart failure, and usually occurs as a result of the development of a pericardial effusion leading to cardiac tamponade. Even rarer still, is the manifestation of constrictive pericarditis. We report a case of sarcoidosis with lung, pleural, and pericardial involvement with effusive-constrictive pericarditis leading to cardiac tamponade. CASE PRESENTATION: A 34-year-old Caucasian man presented for evaluation of a history of worsening exertional dyspnea, edema, and weight loss. A high-resolution chest computed tomography showed diffuse pulmonary nodules with upper lobe predominance and in a perilymphatic distribution; large right pleural effusion; and large pericardial effusion with pericardial thickening. A transthoracic echocardiogram demonstrated early tamponade physiology for which a pericardial drain was placed. After removal of the drain he developed cardiogenic shock from cardiac tamponade attributed to the reaccumulation of a pericardial effusion and urgent pericardial window was performed. Serial echocardiography was concerning for organization and localization of the pericardial fluid. Cardiac magnetic resonance imaging demonstrated a significant reduction in pericardial slippage between the parietal and visceral layers around the heart collectively suggestive of constrictive pericarditis. Confirmation of effusive-constrictive pericarditis was noted on right heart catheterization. He then underwent pericardiectomy, which on histopathologic evaluation demonstrated non-necrotizing granulomas, thus confirming pericardial involvement of sarcoidosis. CONCLUSIONS: We report a case demonstrating unique manifestations of sarcoidosis; effusive-constrictive pericarditis presenting with acute congestive heart failure.


Assuntos
Derrame Pericárdico/etiologia , Pericardite Constritiva/etiologia , Sarcoidose/complicações , Adulto , Cateterismo Cardíaco , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Ecocardiografia , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Derrame Pericárdico/diagnóstico por imagem , Pericardite Constritiva/diagnóstico por imagem
13.
BMC Cardiovasc Disord ; 20(1): 67, 2020 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-32028901

RESUMO

BACKGROUND: Cardiac tamponade is a rare but serious complication of Takotsubo cardiomyopathy (TC). Two cases of cardiac tamponade subsequent to TC have been reported. The pericardial effusion in these cases was hemorrhagic and caused by ventricular rupture. Cardiac tamponade induced by an inflammatory effusion complicated with TC has not been reported. This is the first case report of TC, which developed cardiac tamponade during the recovery phase with a large volume non-hemorrhagic inflammatory effusion. CASE PRESENTATION: We describe a case of an 81-year-old woman admitted to our hospital because of severe chest pain. Her symptoms began soon after her son's hospitalization. We diagnosed her with TC based on results of an electrocardiogram, echocardiogram, and emergent coronary angiography. Her symptoms and left ventricular dysfunction improved gradually. She developed newly confirmed chest pain and dyspnea on day 9 after admission. A large pericardial effusion developed, resulting in cardiac tamponade. Her symptoms and hemodynamic status improved immediately after the pericardiocentesis. The effusion was non-hemorrhagic and exudative. No specific signs of infection, collagen disease, or malignant tumors were observed, except for TC. CONCLUSIONS: We experienced a case of circulatory collapse induced by TC-related inflammatory pericardial effusion at recovery phase. This case emphasizes the importance of careful follow-up even after improved left ventricular dysfunction in a patient with TC.


Assuntos
Tamponamento Cardíaco/etiologia , Derrame Pericárdico/etiologia , Cardiomiopatia de Takotsubo/complicações , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/fisiopatologia , Tamponamento Cardíaco/cirurgia , Feminino , Hemodinâmica , Humanos , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/fisiopatologia , Derrame Pericárdico/cirurgia , Pericardiocentese , Recuperação de Função Fisiológica , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Cardiomiopatia de Takotsubo/fisiopatologia , Resultado do Tratamento , Função Ventricular Esquerda
15.
J Am Coll Cardiol ; 75(1): 76-92, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31918837

RESUMO

Pericarditis refers to the inflammation of the pericardial layers, resulting from a variety of stimuli triggering a stereotyped immune response, and characterized by chest pain associated often with peculiar electrocardiographic changes and, at times, accompanied by pericardial effusion. Acute pericarditis is generally self-limited and not life-threatening; yet, it may cause significant short-term disability, be complicated by either a large pericardial effusion or tamponade, and carry a significant risk of recurrence. The mainstay of treatment of pericarditis is represented by anti-inflammatory drugs. Anti-inflammatory treatments vary, however, in both effectiveness and side-effect profile. The objective of this review is to summarize the up-to-date management of acute and recurrent pericarditis.


Assuntos
Anti-Inflamatórios/uso terapêutico , Gerenciamento Clínico , Pericardite/diagnóstico por imagem , Pericardite/terapia , Doença Aguda , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/fisiopatologia , Tamponamento Cardíaco/terapia , Ecocardiografia/métodos , Eletrocardiografia/métodos , Humanos , Pericardite/fisiopatologia , Recidiva , Literatura de Revisão como Assunto , Tomografia Computadorizada por Raios X/métodos
18.
A A Pract ; 14(4): 102-105, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31842197

RESUMO

Extrinsic compression of the heart consequent to intrapleural fluid is a rare cause of cardiac tamponade. Cases of massive hemothorax resulting in external cardiac tamponade due to injury of the internal thoracic artery (ITA) following blunt or penetrating trauma have been described in the literature. Here, we present a case of iatrogenic injury to the right ITA complicating mastectomy and deep inferior epigastric perforator flap reconstruction. It manifested as hemodynamic instability that persisted despite aggressive fluid resuscitation. Investigation with an intraoperative transesophageal echocardiogram demonstrated cardiac tamponade secondary to a massive hemothorax which resolved following surgical placement of an intercostal drain.


Assuntos
Neoplasias da Mama/cirurgia , Tamponamento Cardíaco/diagnóstico por imagem , Retalhos de Tecido Biológico/efeitos adversos , Artéria Torácica Interna/lesões , Mastectomia/efeitos adversos , Tamponamento Cardíaco/etiologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Feminino , Hemodinâmica , Hemotórax/complicações , Hemotórax/etiologia , Humanos , Doença Iatrogênica , Mamoplastia/efeitos adversos , Artéria Torácica Interna/diagnóstico por imagem , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Curr Cardiol Rep ; 21(11): 144, 2019 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-31758271

RESUMO

PURPOSE OF REVIEW: To review the echo-Doppler findings in effusive-constrictive pericarditis (ECP). ECP corresponds to the coexistence of a hemodynamically significant pericardial effusion and markedly reduced compliance of the pericardium, manifested by constrictive physiology post-pericardiocentesis. RECENT FINDINGS: We summarize herein the recent observations regarding the prevalence of ECP based on echocardiography as well as the pre- and post-pericardiocentesis echo-Doppler features of ECP. ECP diagnosed by echocardiography was seen in approximately 15% of patients with ECP pre- and post-pericardiocentesis echo-Doppler findings sharing features with both cardiac tamponade and constrictive pericarditis. ECP post-pericardiocentesis is common but its natural history in the current era might be better than previously reported. Further studies and (particularly simultaneous echocardiography-cardiac catheterization) are still critically needed to better understand the underlying hemodynamics of ECP. Moreover, it remains to be determined whether pre- and post-pericardiocentesis echo-Doppler findings can be used to prognosticate or to guide therapy of those undergoing pericardiocentesis.


Assuntos
Tamponamento Cardíaco/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Pericardite Constritiva/diagnóstico por imagem , Ultrassonografia Doppler Dupla/métodos , Tamponamento Cardíaco/cirurgia , Humanos , Derrame Pericárdico/cirurgia , Pericardiectomia , Pericardiocentese , Pericardite Constritiva/cirurgia
20.
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
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