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1.
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
2.
Intern Med ; 58(20): 3045-3050, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31243203

RESUMO

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by asthma, eosinophilia, and diffuse eosinophilic infiltration. Although cardiovascular involvement is common and a leading cause of EGPA-related mortality, severe pericarditis-led cardiac tamponade occurs rarely. We herein report a 72-year-old man with anti-proteinase 3 (anti-PR3) anti-neutrophil cytoplasmic antibody (ANCA)-positive EGPA diagnosed by the presence of cardiac tamponade, which responded quickly to pericardiocentesis and a single administration of prednisolone. This is the first case of anti-PR3 ANCA-positive EGPA with cardiac tamponade; the patient displayed clinical features of both ANCA-positive and ANCA-negative cases.


Assuntos
Tamponamento Cardíaco/etiologia , Eosinofilia/complicações , Granulomatose com Poliangiite/complicações , Mieloblastina/imunologia , Idoso , Anticorpos Anticitoplasma de Neutrófilos/imunologia , Tamponamento Cardíaco/diagnóstico , Diagnóstico Diferencial , Ecocardiografia , Eosinofilia/diagnóstico , Eosinofilia/metabolismo , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/metabolismo , Humanos , Masculino , Mieloblastina/metabolismo , Tomografia Computadorizada por Raios X
3.
Int Heart J ; 60(4): 1009-1012, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31204372

RESUMO

Spontaneous coronary artery rupture (SCAR) is an extremely rare, life-threatening entity without any previous underlying diseases. The clinical presentation may differ according to the site of the rupture and some patients may deteriorate early into sudden death due to the abrupt evolution of the associated cardiac tamponade and cardiogenic shock.1) The correct diagnosis of SCAR deserves a high level of suspicion. It may be confirmed as a differential diagnosis in patients with cardiac tamponade using transthoracic echocardiography (TTE) and computed tomography angiography (CTA) following emergency pericardiocentesis, and a definite diagnosis can be achieved by selective angiography. Although SCAR is associated with a dismal prognosis, some patients have recovered through emergency surgical operations or catheter interventions.2) We report the case of a patient presenting cardiac tamponade and cardiogenic shock due to spontaneous rupture of the circumflex branch of the left coronary artery, which was successfully isolated by bilateral ligation.


Assuntos
Tamponamento Cardíaco/etiologia , Doença da Artéria Coronariana/complicações , Vasos Coronários/diagnóstico por imagem , Choque Cardiogênico/etiologia , Doença Aguda , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/cirurgia , Humanos , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Pericardiocentese , Ruptura Espontânea , Choque Cardiogênico/diagnóstico , Choque Cardiogênico/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos
5.
Ir Med J ; 3(112): 902, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-31124350

RESUMO

Aim To report the first case of cardiac tamponade related to Infliximab induction therapy in an Ulcerative Colitis patient. Methods Review of published case reports. Results This complication was likely due to a type 3 hypersensitivity immune-complex reaction resulting in a reactive pericardial effusion Discussion Though rare, this case demonstrates how autoimmune reaction to anti-TNF𝛼 therapy can initially mimic infection, as our patient presented with tachycardia, hypotension, raised inflammatory and infective markers and fever.


Assuntos
Tamponamento Cardíaco/induzido quimicamente , Colite Ulcerativa/tratamento farmacológico , Fármacos Gastrointestinais/efeitos adversos , Infliximab/efeitos adversos , Autoimunidade , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/imunologia , Tamponamento Cardíaco/terapia , Colite Ulcerativa/imunologia , Feminino , Fármacos Gastrointestinais/administração & dosagem , Fármacos Gastrointestinais/imunologia , Humanos , Infliximab/administração & dosagem , Infliximab/imunologia , Pessoa de Meia-Idade , Derrame Pericárdico/induzido quimicamente , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/imunologia , Derrame Pericárdico/terapia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/imunologia
6.
Scand Cardiovasc J ; 53(2): 104-109, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30835565

RESUMO

OBJECTIVES: To ascertain whether extended chest tube drainage decreases the occurrence of late tamponade after cardiac surgery. DESIGN: All patients undergoing cardiac surgery at the Tampere University Heart Hospital, Tampere, Finland, between the 23rd of October 2015 and the 17th of August 2016 were included. The first 260 consecutive patients were treated according to a short drainage protocol, in which the mediastinal chest tubes were removed during the first postoperative day unless producing >50ml/h, and the following 224 consecutive patients by an extended drainage protocol, in which the mediastinal chest tubes were kept at least until the second postoperative day, and thereafter if producing >50ml/4h. The incidence of late tamponade and the length and course of postoperative hospitalization, including the development of complications, were compared. RESULTS: The occurrence of late cardiac tamponade was 8.8% following the short drainage protocol and 3.6% after the extended drainage protocol, p = .018. There were no statistically significant differences in the demographics, medical history, or the procedures performed between the study groups. The in-hospital mortality rate was 3.5%, the stroke rate was 2.1%, and the deep sternal wound infection rate was 1.7%, with no statistically significant differences between the groups. There were no differences in the need for reoperations for bleeding, infection rate, need for pleurocentesis, occurrence of atrial fibrillation, or the length of hospitalization between the groups. CONCLUSIONS: Longer mediastinal chest tube drainage after cardiac surgery is associated with a significantly lower incidence of late cardiac tamponade.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Tamponamento Cardíaco/prevenção & controle , Tubos Torácicos , Drenagem/instrumentação , Idoso , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/mortalidade , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/mortalidade , Drenagem/efeitos adversos , Drenagem/mortalidade , Feminino , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
7.
Am J Cardiol ; 123(3): 498-506, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30477799

RESUMO

Although echocardiography is usually diagnostic of cardiac tamponade, it may not be readily available at the point-of-care. We sought to develop and validate a measurement of respirophasic variation in the amplitude of pulse oximetry plethysmographic waveforms as a diagnostic tool for cardiac tamponade. Pulse oximetry plethysmographic waveforms were recorded, and the ratio of maximum-to-minimum measured amplitude of these waveforms from one respiratory cycle was calculated by blinded observers. Ratios from 3 consecutive respiratory cycles were then averaged to derive an "oximetry paradoxus" ratio. Cardiac tamponade was independently confirmed or excluded according to a "blinded" objective interpretation of echocardiography or right heart catheterization. Seventy four subjects were enrolled (51% men; mean age 54 ± 15 years); 19 of whom had cardiac tamponade. Oximetry paradoxus area under the curve for diagnosis of cardiac tamponade was 0.90 (95% confidence interval, 0.84 to 0.97); its diagnostic performance was superior to sphygmomanometer-measured pulsus paradoxus (area under the curve difference = 0.16, p = 0.022). In a derivation cohort (n = 37; tamponade, 9 cases), 3 diagnostic oximetry paradoxus thresholds were identified and validated in an independent validation cohort (n = 37; tamponade, 10 cases): 1.2 (100% sensitivity, 44% specificity), 1.5 (80% sensitivity, 81% specificity), and 1.7 (80% sensitivity, 89% specificity). Furthermore, oximetry paradoxus was significantly reduced after draining pericardial fluid. In conclusion, we defined and validated oximetry paradoxus as a simple and ubiquitous point-of-care test to diagnose cardiac tamponade using respirophasic changes in pulse plethysmography waveforms. This test can aid in identifying patients with cardiac tamponade, thus expediting confirmatory testing and life-saving treatment.


Assuntos
Tamponamento Cardíaco/diagnóstico , Oximetria , Tamponamento Cardíaco/terapia , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Janela Pericárdica , Pericardiocentese , Pletismografia , Sistemas Automatizados de Assistência Junto ao Leito , Estudos Prospectivos , Respiração , Sensibilidade e Especificidade , Esfigmomanômetros
9.
J Cardiothorac Vasc Anesth ; 33(1): 184-199, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29735219

RESUMO

Patients with pericardial disease often require interventional therapies or surgery, making it essential for anesthesiologists to understand the altered physiology of these disease states and the resultant impact on perioperative management. The broad spectrum of syndromes involving the pericardium present with varying degrees of clinical significance, from asymptomatic presentations to life-threatening emergencies. Impaired diastolic filling of the heart represents a common theme of pericardial disease, with the rate of onset of pericardial pathology largely determining the extent of this impairment and subsequent severity of presentation. This review highlights recent updates in the literature regarding the diagnostic evaluation, medical therapy, and invasive therapeutic procedures for common pericardial syndromes from the perspective of a perioperative physician.


Assuntos
Tamponamento Cardíaco/etiologia , Diagnóstico por Imagem/métodos , Derrame Pericárdico/diagnóstico , Pericardiectomia/métodos , Pericardite Constritiva/diagnóstico , Pericárdio/diagnóstico por imagem , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Humanos , Derrame Pericárdico/complicações , Derrame Pericárdico/cirurgia , Pericardiocentese/métodos , Pericardite Constritiva/complicações , Pericardite Constritiva/cirurgia
10.
Interact Cardiovasc Thorac Surg ; 28(6): 999-1000, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30508174

RESUMO

The isolated coronary sinus (CS) rupture causing cardiac tamponade following blunt chest trauma is a very rare and very unique traumatic form of cardiac tamponade. Prompt recognition of this injury is crucial for patient survival. CS injuries are frequently difficult to repair and are potentially lethal. A meticulous repair carried out on an arrested, empty and well-protected heart is recommended to achieve secure haemostasis and CS patency. To our knowledge, this is the first report on the successful repair of isolated CS rupture following blunt chest trauma.


Assuntos
Tamponamento Cardíaco/etiologia , Seio Coronário/lesões , Traumatismos Cardíacos/complicações , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Acidentes de Trânsito , Idoso , Procedimentos Cirúrgicos Cardíacos/métodos , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Seio Coronário/diagnóstico por imagem , Seio Coronário/cirurgia , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/cirurgia , Humanos , Imagem Tridimensional , Masculino , Tomografia Computadorizada Multidetectores , Ruptura , Traumatismos Torácicos/diagnóstico , Ferimentos não Penetrantes/diagnóstico
12.
Heart ; 105(6): 477-481, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30274986

RESUMO

OBJECTIVE: Aim of this paper is to evaluate the outcomes of 'idiopathic' chronic large pericardial effusions without initial evidence of pericarditis. METHODS: All consecutive cases of idiopathic chronic large pericardial effusions evaluated from 2000 to 2015 in three Italian tertiary referral centres for pericardial diseases were enrolled in a prospective cohort study. The term 'idiopathic' was applied to cases that performed a complete diagnostic evaluation to exclude a specific aetiology. A clinical and echocardiographic follow-up was performed every 3-6 months. RESULTS: 100 patients were included (mean age 61.3±14.6 years, 54 females, 44 patients were asymptomatic according to clinical evaluation) with a mean follow-up of 50 months. The baseline median size of the effusion (evaluated as the largest end-diastolic echo-free space) was 25 mm (IQR 8) and decreased to a mean value of 7 mm (IQR 19; p<0.0001) with complete regression in 39 patients at the end of follow-up. There were no new aetiological diagnoses. Adverse events were respectively: cardiac tamponade in 8 patients (8.0%), pericardiocentesis in 30 patients (30.0%), pericardial window in 12 cases (12.0%) and pericardiectomy in 3 patients (3.0%). Recurrence-free survival and complications-free survival was better in patients treated without interventions (log rank p=0.0038). CONCLUSIONS: The evolution of 'idiopathic' chronic large pericardial effusions is usually benign with reduction of the size of the effusion in the majority of cases, and regression in about 40% of cases. The risk of cardiac tamponade is 2.2%/year and recurrence/complications survival was better in patients treated conservatively without interventions.


Assuntos
Doenças Assintomáticas/epidemiologia , Tamponamento Cardíaco , Derrame Pericárdico , Pericardiectomia , Pericardiocentese , Pericardite , Idoso , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/epidemiologia , Tamponamento Cardíaco/etiologia , Ecocardiografia/métodos , Feminino , Seguimentos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/complicações , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/epidemiologia , Pericardiectomia/métodos , Pericardiectomia/estatística & dados numéricos , Pericardiocentese/métodos , Pericardiocentese/estatística & dados numéricos , Pericardite/complicações , Pericardite/diagnóstico , Pericardite/epidemiologia , Estudos Prospectivos , Recidiva , Fatores de Risco , Índice de Gravidade de Doença , Análise de Sobrevida
13.
Ann Thorac Surg ; 107(3): e175-e176, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30266619

RESUMO

Nickel hypersensitivity has been reported in up to 15% of the general population, and cases of nickel allergy have been correlated with use of stainless steel wires. This is a case report of a 48-year-old woman with history of contact allergy to metal who underwent elective coronary artery bypass grafting. Severe systemic inflammatory response and cardiac tamponade due to edema of mediastinal tissues developed postoperatively. The patient required removal of stainless steel wires and delayed sternal closure with Ethibond (Ethicon, Somerville, NJ) sutures in addition to intravenous steroids. In patients with hypersensitivity to nickel, other alternatives closure methods should be considered.


Assuntos
Fios Ortopédicos/efeitos adversos , Tamponamento Cardíaco/etiologia , Ponte de Artéria Coronária/efeitos adversos , Esternotomia/efeitos adversos , Esterno/cirurgia , Suturas/efeitos adversos , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia , Reoperação , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/cirurgia
15.
J Infect Chemother ; 25(2): 151-153, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30098916

RESUMO

We present an unusual case of cardiac tamponade in a 17-year-old girl immunocompetent patient due to Salmonella enterica ssp. bredeney following infection of a bronchogenic cyst. The patient was admitted to hospital with pleuritic chest pain, dyspnoea and fever. Pulmonary angio-CT showed a bronchogenic cyst compressing the left atrium. The echocardiography showed diffuse pericardial effusion with right ventricular collapse consistent with cardiac tamponade. Pericardiocentesis was performed and microbiological cultures of the pericardial fluid became positive for Salmonella species confirmed later as bredeney subspecies by PCR. Empirical antibiotherapy was started with intravenous (IV) ceftriaxone. Bronchogenic cyst infection was suspected and confirmed by 18FDG PET CT. The patient was successfully treated by complete resection of the cyst and continuation of IV ceftriaxone followed by oral amoxicillin/clavulanate for a total duration of 6 weeks. She then completely recovered and didn't present any relapse after 6 months of follow up.


Assuntos
Cisto Broncogênico , Tamponamento Cardíaco , Infecções por Salmonella , Salmonella , Adolescente , Antibacterianos/uso terapêutico , Cisto Broncogênico/complicações , Cisto Broncogênico/diagnóstico , Cisto Broncogênico/tratamento farmacológico , Cisto Broncogênico/microbiologia , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Feminino , Humanos , Infecções por Salmonella/complicações , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/tratamento farmacológico , Infecções por Salmonella/microbiologia
17.
Medicine (Baltimore) ; 97(51): e13708, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30572500

RESUMO

RATIONALE: Systemic lupus erythematosus (SLE) is a connective tissue disease that has many clinical manifestations. However, cardiac tamponade has been rarely reported especially as an initial presenting feature of systemic lupus erythematosus. Herein, we describe a case of cardiac tamponade as the first presentation of systemic lupus erythematosus in a male and presented the course of diagnosis and treatment of this patient. PATIENT CONCERNS: A 32-year-old male patient developed a rapid progression of pericardial effusion and he was almost healthy in the past. Vital signs were significantly marked by high fever, tachycardia, and accelerated breathing rate of 37 times per minute. The ANA titer was 1:320 and anti-dsDNA was positive during his hospitalization. The complement levels were decreased but the ESR and the CRP level were increased obviously. Soon after, he appeared anemic and thrombocytopenic. DIAGNOSES: The diagnosis of SLE was made based on the clinical and biochemical findings according to 2012 SLICC SLE Criteria. INTERVENTIONS: The interventions included use CT-guided pericardial puncture to relieve symptoms in time; utilize high-dose glucocorticoids and immunosuppressants to therapy SLE; closely monitor the vital signs, blood routine, blood biochemical indicators, and volume of pericardial effusion. OUTCOMES: After 2 months, the symptoms were disappeared almost completely and TTE showed his pericardial effusion had decreased significantly. LESSONS: We should also keep SLE in mind when assessing male patients with pericardial effusions. Early examinations of sero-immunological markers and closely monitoring the performances are important for the diagnosis of the disease. Early pericardial puncture can quickly relieve symptoms and improve prognosis.


Assuntos
Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Adulto , Tamponamento Cardíaco/terapia , Diagnóstico Diferencial , Humanos , Lúpus Eritematoso Sistêmico/terapia , Masculino
18.
Medicine (Baltimore) ; 97(49): e13532, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30544457

RESUMO

RATIONALE: Radiofrequency ablation (RFA) is a safe and effective local treatment modality with a low complication rate and is commonly used to treat hepatocellular carcinoma (HCC). The clinical outcome of RFA may be closely related to the location, size, and shape of index tumors, and major complications, including hemorrhage, liver abscess, infarction, visceral organ perforation, hemothorax, pneumothorax, tumoral seeding, and hepatic failure. Cardiac tamponade is a rare and serious life-threatening complication associated with RFA. To date, a review of the medical literature reported 5 cases of cardiac tamponade after RFA for HCC. Herein, we report another case of cardiac tamponade after RFA for HCC in a 56-year-old man. PATIENT CONCERNS: He had suffered from liver cirrhosis due to alcohol abuse. He had chronic obstructive pulmonary disease. Magnetic resonance imaging showed a 3.0-cm exophytic subcapsular HCC in segment IVa of left hepatic lobe. As the patient was at high risk for surgery because of poor lung function, RFA was selected as the treatment of choice. The index tumor was located in the vicinity of the diaphragm and colon. During RFA procedure, thermal injury to the adjacent diaphragm and colon was minimized by introducing artificial ascites. Bleeding or tumoral seeding was prevented by ablating the electrode track during electrode retraction. DIAGNOSIS: Two hours after RFA, the patient presented with dyspnea, chest discomfort, and low blood pressure (80/60 mm Hg), suggesting cardiac tamponade. Immediate follow-up contrast-enhanced computed tomography image depicted the slightly high attenuated hemopericardium. Transthoracic echocardiography (TTE) showed a moderate amount of pericardial effusion with tamponade and a large hematoma. INTERVENTIONS: Under fluoroscopy and portable echocardiography guidance, a cardiologist immediately inserted a 7-French pigtail catheter into the pericardial space and collected more than 200 cc of bloody pericardial fluid. OUTCOMES: After pericardiocentesis, the patient's symptoms and hemodynamic status were dramatically improved. Follow-up TTE showed scanty amount of pericardial effusion and the drainage catheter was removed. The patient was discharged. LESSONS: When treating HCC in the left lobe (especially segments II and IVa), attention should be paid to cardiac tamponade. The early diagnosis and immediate treatment of cardiac tamponade may increase the chance of cure.


Assuntos
Carcinoma Hepatocelular/cirurgia , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Neoplasias Hepáticas/cirurgia , Complicações Pós-Operatórias , Ablação por Radiofrequência , Tamponamento Cardíaco/terapia , Diagnóstico Precoce , Humanos , Masculino , Pessoa de Meia-Idade
19.
BMJ Case Rep ; 11(1)2018 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-30567271

RESUMO

A 24-year-old man with previous matched unrelated donor allogenic bone marrow transplant for aplastic anaemia and chronic graft versus host disease on steroid taper presented with progressively worsening anasarca. CT revealed large pericardial effusion, while echocardiogram was concerning for early tamponade physiology. He underwent emergent pericardiocentesis with pericardial drain placement. Extensive rheumatological and infectious work-up was unrevealing with patient's presentation attributed to pericardial graft versus host disease. This highlights the need of physicians to be aware of pericardial serositis as a complication of graft versus host disease due to its life-threatening complications, which require immediate intervention.


Assuntos
Anemia Aplástica/terapia , Transplante de Medula Óssea/efeitos adversos , Tamponamento Cardíaco/diagnóstico , Edema/etiologia , Doença Enxerto-Hospedeiro/diagnóstico , Derrame Pericárdico/diagnóstico , Pericardiocentese/métodos , Anti-Inflamatórios/uso terapêutico , Tamponamento Cardíaco/fisiopatologia , Tamponamento Cardíaco/terapia , Ecocardiografia , Edema/fisiopatologia , Edema/terapia , Doença Enxerto-Hospedeiro/fisiopatologia , Doença Enxerto-Hospedeiro/terapia , Humanos , Masculino , Metilprednisolona/uso terapêutico , Derrame Pericárdico/etiologia , Derrame Pericárdico/fisiopatologia , Derrame Pericárdico/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
20.
Med Arch ; 72(4): 285-288, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30514996

RESUMO

Aim: The aim of this case report is to show the significance of the cardiac tamponade, it's timely diagnosis and to present the unusual approach of the treatment. That was conducted with corticosteroids when the surgical procedure gave no results in rare cases like this. Case Report: This paper presents the case of a man aged 72 years with a verified tamponade of pericardium. A large pericardial effusion with tamponade signs was verified by ultrasound and computerized tomography (CT) of the chest in a hemodynamically stable patient, and in the inability to evacuate the same, with pericardial fenestration, was successfully treated with corticosteroids. Conclusion: A large pericardial effusion with the signs of tamponade verified by echocardiography and computerized tomography, in hemodynamically stable patient, and in the inability to evacuate the same by fenestration, was treated successfully with corticosteroids.


Assuntos
Corticosteroides/uso terapêutico , Tamponamento Cardíaco/tratamento farmacológico , Tamponamento Cardíaco/etiologia , Infarto do Miocárdio/cirurgia , Revascularização Miocárdica/efeitos adversos , Idoso , Bósnia e Herzegóvina , Tamponamento Cardíaco/diagnóstico , Humanos , Masculino , Resultado do Tratamento
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