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1.
Cardiovasc Ther ; 2021: 1716546, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33488770

RESUMO

Ventricular free wall rupture (FWR) is a catastrophic complication after acute myocardial infarction (AMI). However, patients with FWR die of cardiac tamponade secondary to intrapericardial hemorrhage that can be treated if properly diagnosed. Unfortunately, FWR was still not diagnosed and classified quickly and accurately. The aim of this study was to present a new clinical classification for FWR. Seventy-eight patients with FWR after STEMI were enrolled in the study. We classified FWR, according to clinical situations after onset, into the cardiac arrest type, unstable type, and stable type. The cardiac arrest type was the most common type, accounting for about 83.3%. 90.8% of patients of this type were complicated with electromechanical dissociation at the time of FWR onset, and 100% of patients of this type died in the hospital. The unstable type was characterized by sudden clinical condition changes with moderate/massive pericardial effusion. In this study, 9.0% of patients were diagnosed as the unstable type. The average time from onset to death was 4.5 hours. This period was the "golden time" to rescue such patients. The stable types usually have stable hemodynamics, but may worsen, requiring rigorous detection of pericardial effusion and vital signs. In this study, 7.7% of patients were diagnosed as the stable type, and 83.5% of them survived in the hospital. The new clinical classification provides a basis for clinical diagnosis and treatment of FWR. The clinical application of the new classification is expected to improve the prognosis of FWR patients.


Assuntos
Ruptura Cardíaca Pós-Infarto/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Terminologia como Assunto , Idoso , Tamponamento Cardíaco/etiologia , Feminino , Parada Cardíaca/etiologia , Ruptura Cardíaca Pós-Infarto/classificação , Ruptura Cardíaca Pós-Infarto/etiologia , Ruptura Cardíaca Pós-Infarto/mortalidade , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pericárdico/etiologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade
2.
J Med Case Rep ; 15(1): 31, 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33494822

RESUMO

BACKGROUND: Previous reports have shown various cardiac complications to be associated with COVID-19 including: myocardial infarction, microembolic complications, myocardial injury, arrythmia, heart failure, coronary vasospasm, non-ischemic cardiomyopathy, stress (Takotsubo) cardiomyopathy, pericarditis and myocarditis. These COVID-19 cardiac complications were associated with respiratory symptoms. However, our case illustrates that COVID-19 myopericarditis with cardiac tamponade can present without respiratory symptoms. CASE PRESENTATION: A 58-year-old Caucasian British woman was admitted with fever, diarrhoea and vomiting. She developed cardiogenic shock and Transthoracic echocardiogram (TTE) found a pericardial effusion with evidence of cardiac tamponade. A nasopharyngeal swab showed a COVID-19 positive result, despite no respiratory symptoms on presentation. A pericardial drain was inserted and vasopressor support required on intensive treatment unit (ITU). The drain was removed as she improved, an antibiotic course was given and she was discharged on day 12. CONCLUSIONS: Our case demonstrates that patients without respiratory symptoms could have COVID-19 and develop cardiac complications. These findings can aid timely diagnosis of potentially life-threatening COVID-19 myopericarditis with cardiac tamponade.


Assuntos
/complicações , Tamponamento Cardíaco/etiologia , Miocardite/etiologia , Pericardite/etiologia , Feminino , Humanos , Pessoa de Meia-Idade
3.
Anaesthesia ; 76(1): 19-26, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32406071

RESUMO

Over 30,000 adult cardiac operations are carried out in the UK annually. A small number of these patients need to return to theatre in the first few days after the initial surgery, but the exact proportion is unknown. The majority of these resternotomies are for bleeding or cardiac tamponade. The Association of Cardiothoracic Anaesthesia and Critical Care carried out a 1-year national audit of resternotomy in 2018. Twenty-three of the 35 centres that were eligible participated. The overall resternotomy rate (95%CI) within the period of admission for the initial operation in these centres was 3.6% (3.37-3.85). The rate varied between centres from 0.69% to 7.6%. Of the 849 patients who required resternotomy, 127 subsequently died, giving a mortality rate (95%CI) of 15.0% (12.7-17.5). In patients who underwent resternotomy, the median (IQR [range]) length of stay on ICU was 5 (2-10 [0-335]) days, and time to tracheal extubation was 20 (12-48 [0-2880]) hours. A total of 89.3% of patients who underwent resternotomy were transfused red cells, with a median (IQR [range]) of 4 (2-7 [1-1144]) units of red blood cells. The rate (95%CI) of needing renal replacement therapy was 23.4% (20.6-26.5). This UK-wide audit has demonstrated that resternotomy after cardiac surgery is associated with prolonged intensive care stay, high rates of blood transfusion, renal replacement therapy and very high mortality. Further research into this area is required to try to improve patient care and outcomes in patients who require resternotomy in the first 24 h after cardiac surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos/mortalidade , Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos , Reoperação/mortalidade , Reoperação/estatística & dados numéricos , Esternotomia/mortalidade , Esternotomia/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Extubação , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/cirurgia , Cuidados Críticos/estatística & dados numéricos , Transfusão de Eritrócitos/mortalidade , Transfusão de Eritrócitos/estatística & dados numéricos , Feminino , Humanos , Incidência , Tempo de Internação , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/cirurgia , Terapia de Substituição Renal/mortalidade , Terapia de Substituição Renal/estatística & dados numéricos , Reino Unido/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-33331520

RESUMO

Dengue is a viral disease, caused by an arbovirus of the genus Flavivirus. In Brazil, its incidence rate is high with a broad clinical spectrum. This report discusses a rare case of dengue associated with cutaneous leukocytoclastic vasculitis and pericardial effusion with eminence of cardiac tamponade in a previously healthy patient with no comorbidities. The serology for dengue was positive and the histopathological analysis of the cutaneous lesions confirmed the diagnosis of leukocytoclastic vasculitis. After receiving treatment, the patient's condition greatly improved.


Assuntos
Tamponamento Cardíaco/etiologia , Dengue/complicações , Derrame Pericárdico/etiologia , Vasculite Leucocitoclástica Cutânea/diagnóstico , Brasil , Tamponamento Cardíaco/diagnóstico , Dengue/diagnóstico , Humanos , Masculino , Pele , Vasculite Leucocitoclástica Cutânea/complicações , Adulto Jovem
5.
BMJ Case Rep ; 13(12)2020 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-33372015

RESUMO

We describe the case of an 86-year-old man with a background of severe left ventricular dysfunction and ischaemic cardiomyopathy who, having been optimised for heart failure therapy in hospital, unexpectedly deteriorated again with hypotension and progressive renal failure over the course of 2 days. Common causes of decompensation were ruled out and a bedside echocardiogram unexpectedly diagnosed new pericardial effusion with tamponade physiology. The patient underwent urgent pericardiocentesis and 890 mL of haemorrhagic fluid was drained. Common causes for haemopericardium were ruled out, and the spontaneous haemopericardium was thought to be related to introduction of rivaroxaban anticoagulation. The patient made a full recovery and was well 2 months following discharge. This case highlights the challenges of diagnosing cardiac tamponade in the presence of more common disorders that share similar non-specific clinical features. In addition, this case adds to growing evidence that therapy with direct oral anticoagulants can be complicated by spontaneous haemopericardium, especially when coadministered with other agents that affect clotting, renal dysfunction and cytochrome P3A5 inhibitors.


Assuntos
Anticoagulantes/efeitos adversos , Tamponamento Cardíaco/etiologia , Insuficiência Cardíaca/complicações , Isquemia Miocárdica/complicações , Derrame Pericárdico/complicações , Rivaroxabana/efeitos adversos , Lesão Renal Aguda/etiologia , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/terapia , Inibidores do Citocromo P-450 CYP3A/efeitos adversos , Diagnóstico Diferencial , Drenagem , Ecocardiografia , Humanos , Hipotensão/etiologia , Masculino , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/terapia , Disfunção Ventricular Esquerda/complicações
6.
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
7.
Acute Med ; 19(2): 106-109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32840262

RESUMO

Syncope is a common clinical presentation and accounts for 1-3% of Emergency Department (ED) visits. Cough syncope is a rare type of situational syncope, often caused by respiratory conditions like bronchial asthma and chronic obstructive pulmonary disease. Cough syncope due to pericardial effusion is a rare but treatable condition. Delay in diagnosis can lead to fatal complications due to cardiac tamponade. We present a case of recurrent cough syncope caused by large pericardial effusion.


Assuntos
Tamponamento Cardíaco , Derrame Pericárdico , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Tosse/etiologia , Serviço Hospitalar de Emergência , Humanos , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/etiologia , Síncope/diagnóstico , Síncope/etiologia
8.
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 , /terapia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Trombocitopenia/etiologia , Trombose Venosa/etiologia , Disfunção Ventricular Esquerda/diagnóstico por imagem
9.
Paediatr Int Child Health ; 40(4): 261-267, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32662356

RESUMO

Inflammatory myofibroblastic tumour usually has a benign course and is very rarely associated with the heart. It can have life-threatening consequences, depending on its position or the presence of aggressive and metastatic complications. A 3-month-old boy presented with pericardial tamponade and was diagnosed with intrapericardial inflammatory myofibroblastic tumour associated with Coronavirus OC43. A large tumour attached to the left ventricle was completely removed by surgical resection and he made a full recovery. ABBREVIATIONS: ALK: anaplastic lymphoma kinase; CMV: cytomegalovirus; CRP: C-reactive protein; EB: Epstein-Barr virus; ESR: erythrocyte sedimentation rate; IM: inflammatory myofibroblastic tumour; NSAI: non-steroidal anti-inflammatory drugs; PTFE: polytetrafluoroethylene; SMA: smooth muscle actin.


Assuntos
Tamponamento Cardíaco/etiologia , Infecções por Coronavirus/complicações , Coronavirus Humano OC43 , Neoplasias Cardíacas/patologia , Neoplasias de Tecido Muscular/complicações , Infecções por Coronavirus/patologia , Neoplasias Cardíacas/cirurgia , Humanos , Lactente , Inflamação , Masculino , Miofibroblastos/patologia , Neoplasias de Tecido Muscular/patologia , Neoplasias de Tecido Muscular/cirurgia , Derrame Pericárdico/etiologia
10.
J Cardiothorac Surg ; 15(1): 165, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641086

RESUMO

BACKGROUND: We present an unusual case of pericardial tamponade occurring subsequent to a radical right nephrectomy performed entirely through a laparotomy. CASE PRESENTATION: A 43 year old gentleman who presented with large loculated posterior pericardial effusion compressing the left atrium, following a radical nephrectomy performed entirely through a laparotomy. He required an emergency sternotomy, pericardial and pleural drainage. CONCLUSION: Cardiac tamponade is an extremely rare complication of radical nephrectomy. However, any procedure that involves opening of the pericardium does carry a risk of bleeding and therefore cardiac tamponade, particularly in the context of post-operative full anticoagulation.


Assuntos
Tamponamento Cardíaco/cirurgia , Nefrectomia/efeitos adversos , Derrame Pericárdico/cirurgia , Adulto , Fibrilação Atrial/cirurgia , Tamponamento Cardíaco/etiologia , Drenagem , Humanos , Masculino , Nefrectomia/métodos , Derrame Pericárdico/etiologia , Esternotomia
11.
J Card Surg ; 35(8): 2081-2083, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32652645

RESUMO

Cardiac tamponade and its protean presentations are well documented. Tamponade presenting after recent cardiac surgery in a patient on anticoagulation is not unknown. However, severe headache as a presenting feature of tamponade is not documented. We describe how one can be misled into investigating causes of headache while the real cause, tamponade, lies hidden.


Assuntos
Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Cefaleia/etiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Anticoagulantes/uso terapêutico , Ponte de Artéria Coronária sem Circulação Extracorpórea , Diagnóstico Diferencial , Ecocardiografia , Humanos , Veias Jugulares , Masculino , Pessoa de Meia-Idade , Trombose/tratamento farmacológico , Trombose/etiologia , Varfarina/uso terapêutico
12.
Am J Case Rep ; 21: e925554, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32606285

RESUMO

BACKGROUND Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness. However, with rising numbers of cases, multiple reports of cardiovascular manifestations have emerged. We present a case of COVID-19 infection complicated by myopericarditis and tamponade requiring drainage. CASE REPORT An 82-year-old woman with multiple comorbidities presented with five days of productive cough, fever with chills, and intermittent diarrhea. She tested positive for COVID-19. Index EKG revealed new diffuse T-wave inversions and a prolonged QT interval (>500 ms). Troponin was mildly elevated without any anginal symptoms. Hydroxychloroquine and azithromycin were not initiated due to concerns about QT prolongation. The echocardiogram revealed preserved left ventricular (LV) function, a small global pericardial effusion, and apical hypokinesis. Serial echocardiograms revealed an enlarging circumferential pericardial effusion with pacemaker wire reported as 'piercing' the right ventricular (RV) apex alongside early diastolic collapse of the right ventricle, suggesting echocardiographic tamponade. Chest CT revealed extension of the RV pacemaker lead into the pericardial fat. Interestingly, on comparison with a previous chest CT from 2019, similar lead positions were confirmed. Pericardiocentesis was performed with removal of 400 cc exudate. CONCLUSIONS Acute myopericarditis and pericardial effusion can occur in COVID-19 infection, even in the absence of severe pulmonary disease. This case highlights the importance of awareness of rare cardiac manifestations of COVID-19 in the form of acute myopericarditis and cardiac tamponade and their early diagnosis and management.


Assuntos
Betacoronavirus , Tamponamento Cardíaco/etiologia , Diagnóstico Precoce , Miocardite/complicações , Derrame Pericárdico/etiologia , Pericardiocentese/métodos , Pericardite/complicações , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/cirurgia , Ecocardiografia , Feminino , Humanos , Miocardite/diagnóstico , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/cirurgia , Pericardite/diagnóstico , Função Ventricular Esquerda/fisiologia
15.
Herzschrittmacherther Elektrophysiol ; 31(4): 381-387, 2020 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-32676836

RESUMO

Catheter ablation is an established treatment option in patients suffering from symptomatic cardiac arrhythmias. However, despite technical advances, catheter ablation is still associated with an incidence of severe complications of up to 5%. Therefore, electrophysiologists should be trained to prevent complications, maintain a high index of suspicion to recognize them quickly and implement necessary treatment strategies. This article reviews the incidence, risk factors, management and preventative strategies of the major complications associated with ablation procedures such as transseptal puncture-related risks, cardiac tamponade, aortic puncture and air embolism.


Assuntos
Fibrilação Atrial , Tamponamento Cardíaco , Ablação por Cateter , Fibrilação Atrial/cirurgia , Eletrofisiologia Cardíaca , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Ablação por Cateter/efeitos adversos , Humanos , Punções , Resultado do Tratamento
17.
Cir. pediátr ; 33(3): 110-114, jul. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-193551

RESUMO

OBJETIVO: El síndrome del opérculo torácico (SOT) está causado por una compresión del plexo braquial y vasos subclavios en su paso hacia la extremidad superior. Patología típica de mujeres entre 20 y 50 años, que es infrecuente diagnosticar en niños. Presentamos nuestros resultados en el diagnóstico y tratamiento del SOT pediátrico. MATERIAL Y MÉTODOS: Estudio retrospectivo de pacientes diagnosticados de SOT entre diciembre de 2017 y junio de 2018. Se analizaron variables clínicas, radiológicas, quirúrgicas y de evolución. RESULTADOS: Cinco SOT fueron diagnosticados en cuatro pacientes, uno de ellos bilateral. La edad media al diagnóstico fue de 12,5 años (7-15) y hubo una demora en el diagnóstico de 153 días (10-360). SOT venoso (3) y neurológico (2). Presentaron dolor (5/5), edema (4/5), hipoestesia (3/5), disminución de fuerza (3/5) y dolor cervical (2/5). Una paciente presentaba dolor asociado al deporte. El estudio neurofisiológico fue normal en tres casos. Dos pacientes presentaron anomalías óseas por TAC. Se realizaron tres intervenciones quirúrgicas en dos pacientes por abordaje supraclavicular realizando resección de la primera costilla anómala y escalenectomía. Una paciente rechazó la intervención y en otra se mantuvo en una actitud expectante sin reaparición de los síntomas. Seguimiento posoperatorio de 9 meses (6-12) con mejoría progresivas de los síntomas. CONCLUSIÓN: El SOT puede darse en adolescentes, siendo el dolor y edema de la extremidad superior lo más específico. Se recomienda la realización de pruebas de imagen para detectar estructuras anatómicas anómalas. El abordaje supraclavicular se presenta como una técnica segura y eficaz en la descompresión del desfiladero torácico


OBJECTIVE: Thoracic Outlet Syndrome (TOS) is caused by a compression of the brachial plexus and the subclavian vessels in their passage to the upper limb. It mostly occurs in women aged 20-50, so it is infrequent in children. We present our results in the diagnosis and management of pediatric TOS. MATERIALS AND METHODS: Retrospective study of patients diagnosed with TOS between December 2017 and June 2018. Clinical, radiological, surgical, and evolution variables were assessed. RESULTS: Five TOS were diagnosed in 4 patients - one TOS was bilateral. Mean age at diagnosis was 12.5 years (7-15), and there was a delay in diagnosis of 153 days (10-36). TOS was either venous (3) or neurogenic (2). Patients presented with pain (5/5), edema (4/5), hypoesthesia (3/5), decreased strength (3/5), and cervical pain (2/5). One patient presented with sport-related pain. Neurophysiological study was normal in three cases. Two patients presented bone anomalies at CT-scan. Three surgeries were performed in two patients using the supraclavicular approach with resection of the anomalous first rib and scalenectomy. One patient refused surgery, and another patient remained expectant without reappearance of symptoms. Postoperative follow-up was 9 months (6-12), with progressive improvement of symptoms. CONCLUSIONS: TOS may occur in adolescents in the form of upper limb pain and edema. Imaging tests are recommended to detect abnormal anatomical structures. The supraclavicular approach represents a safe and effective technique in decompressing the thoracic outlet


Assuntos
Humanos , Masculino , Adolescente , Criança , Síndrome da Costela Cervical/diagnóstico por imagem , Síndrome da Costela Cervical/cirurgia , Costela Cervical/diagnóstico por imagem , Tamponamento Cardíaco/etiologia , Costela Cervical/cirurgia , Estudos Retrospectivos , Fatores de Risco
18.
Medicine (Baltimore) ; 99(23): e19977, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501965

RESUMO

The clinical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in prior coronary artery bypass graft (pCABG) patients have been investigated; however, the results are inconsistent.The present meta-analysis compared the clinical outcomes of CTO PCI in patients with and without prior CABG (nCABG). The endpoints included technical success, procedural success, all-cause mortality, myocardial infarction (MI), major bleeding, coronary perforation, pericardial tamponade, emergency CABG, and vascular access complication.A total of 7 studies comprising of 11099 patients were included in this meta-analysis. The results showed that compared to nCABG patents, pCABG patients were associated with lower technical success (82.3% versus 87.8%; OR, 0.60; 95% CI, 0.53-0.68; P < .00001; I = 0%) and procedural success (80.4% versus 86.2%; OR, 0.61; 95% CI, 0.53-0.70; P < .00001; I = 10%); a higher risk of all-cause mortality (OR, 2.95; 95% CI, 1.56-5.57; P = 0.0008; I = 0%), MI (OR, 2.30; 95% CI, 1.40-3.80; P = .001; I = 5%), and coronary perforation (OR, 2.16; 95% CI, 1.51-3.08; P < 0.0001; I = 52%). On the other hand, the risk of pericardial tamponade (OR, 0.42; 95% CI, 0.15-1.18; P = .10; I = 21%), major bleeding (OR, 1.51; 95% CI, 0.90-2.53; P = .11; I = 0%), vascular access complication (OR, 1.50; 95% CI, 0.93-2.41; P = .10; I = 0%), and emergency CABG (OR, 0.99; 95% CI, 0.25-3.91; P = .99; I = 0%) was similar in both groups.Compared to nCABG patients, pCABG patients had lower CTO PCI success rates, higher rates of in-hospital mortality, MI, and coronary perforation, and similar risk of pericardial tamponade and vascular complication rates.


Assuntos
Ponte de Artéria Coronária/estatística & dados numéricos , Oclusão Coronária/cirurgia , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Complicações Pós-Operatórias/epidemiologia , Tamponamento Cardíaco/etiologia , Hemorragia/etiologia , Humanos , Infarto do Miocárdio/etiologia , Estudos Observacionais como Assunto , Projetos de Pesquisa , Fatores de Risco
19.
Z Geburtshilfe Neonatol ; 224(4): 187-193, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32575128

RESUMO

Fetal intrapericardial teratomas are rare and benign cardiac tumors. By comprehensive literature retrieval of the pertinent articles published since 2000, 49 articles with 61 cases of intrapericadial teratomas were recruited into this study. The intrapericardial teratomas were found during pregnancy in 55 cases (fetal group), while the tumors were detected until neonatal period in 6 cases (neonatal group). In the fetal group, 15 cases were critical with fetal/neonatal respiratory distress or cardiac tamponade. Antenatal treatments including centesis, shunt placement, open fetal surgery and the ex utero intrapartum treatment were required in 24 (43.6%) fetal cases. Postnatal intubation was required in 19 cases with 18 of them having immediate intubation after birth. Postnatal tumor resection was performed in 41 (95.3%) cases. In neonatal group, 4 neonates had respiratory distress and/or cardiac tamponade. Neonatal intubation was required in 1 (16.7%) patient. Surgical tumor resection was performed in all 6 patients. A comparison between the fetal and neonatal groups revealed that the fetal group was associated with higher refractory effusions while the neonatal group had a higher incidence of respiratory distress. Although the all cause death rate was higher in the fetal group than in the neonatal (25.5 vs. 0%), but lack of a statistical significance. Antenatal treatments for fetal intrapericardial teratomas are feasible but carry higher risks in comparison to neonatal cases.


Assuntos
Tamponamento Cardíaco/etiologia , Neoplasias Cardíacas/cirurgia , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Teratoma/cirurgia , Feminino , Feto , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido , Triagem Neonatal , Pericárdio , Gravidez , Cuidado Pré-Natal , Teratoma/diagnóstico por imagem , Teratoma/patologia , Ultrassonografia Pré-Natal
20.
Gan To Kagaku Ryoho ; 47(6): 881-884, 2020 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-32541160

RESUMO

The causes of cardiac tamponade include neoplastic pericarditis as well as radiation-induced, drug-induced, purulent and iatrogenic pericarditis. Since we can get access to the advanced cancer therapy these days, some of the cardiac tamponade patients can survive longer if we can manage their pericardial effusion well. Here, we will summarize the clinical evidence in cardiac tamponade in patients with malignant tumor, and will discuss about its presentation, diagnosis and management.


Assuntos
Tamponamento Cardíaco , Neoplasias , Tamponamento Cardíaco/etiologia , Humanos , Neoplasias/complicações , Derrame Pericárdico , Pericardite
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