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Jornal Brasileiro de Pneumologia :... Jan 2021
Topics: Echocardiography; Humans; Pericardial Effusion
PubMed: 33503136
DOI: 10.36416/1806-3756/e20200587 -
Revue Medicale de Liege May 2018Cardiac tamponade is a vital emergency. It occurs when the accumulation of intra-pericardial fluid exceeds the pericardial adaptation capacity. Pericardial pressure is... (Review)
Review
Cardiac tamponade is a vital emergency. It occurs when the accumulation of intra-pericardial fluid exceeds the pericardial adaptation capacity. Pericardial pressure is equalized with that of cardiac cavities and severe heart failure occurs, most often rapidly. Several clinical presentations are possible. The diagnosis is based on the assessment of pericardial effusion and its impact on the heart by echocardiography. Supportive treatments have limited effectiveness. The only emergency treatment is drainage of the pericardium by direct puncture or by surgical approach.
Topics: Cardiac Tamponade; Drainage; Echocardiography; Humans; Pericardial Effusion
PubMed: 29926566
DOI: No ID Found -
Current Cardiology Reports Jul 2021Pericardial effusion is a challenging pericardial syndrome and a cause of serious concern for physicians and patients due to its potential progression to... (Review)
Review
PURPOSE OF REVIEW
Pericardial effusion is a challenging pericardial syndrome and a cause of serious concern for physicians and patients due to its potential progression to life-threatening cardiac tamponade. In this review, we summarize the contemporary evidence of the etiology; diagnostic work-up, with particular emphasis on the contribution of multimodality imaging; therapeutic options; and short- and long-term outcomes of these patients.
RECENT FINDINGS
In recent years, an important piece of information has contributed to put together several missing parts of the puzzle of pericardial effusion. The most recent 2015 guidelines of the European Society of Cardiology for the diagnosis and management of pericardial diseases are a valuable aid for a tailored approach to this condition. Actually, current guidelines suggest a 4-step treatment algorithm depending on the presence or absence of hemodynamic impairment; the elevation of inflammatory markers; the presence of a known or first-diagnosed underlying condition, possibly related to pericardial effusion; and finally the duration and size of the effusion. In contrast to earlier perceptions, based on the most recent evidence, it seems that in the subgroup of asymptomatic patients with large (> 2-cm end-diastolic diameter), chronic (> 3 months) C-reactive protein negative, idiopathic (without an apparent cause) pericardial effusion, a conservative approach is the most reasonable option. At present there is an increasing interest in the pericardial syndromes in general and pericardial effusions in specific, which has consistently expanded our knowledge in this "hazy landscape." Apart from general recommendations applied to all cases, an individualized, etiologically driven treatment is of paramount importance.
Topics: Cardiac Tamponade; Cardiology; Hemodynamics; Humans; Pericardial Effusion; Pericardiocentesis
PubMed: 34196832
DOI: 10.1007/s11886-021-01539-7 -
The Journal of International Medical... Nov 2020Chronic massive pericardial effusion without cardiac tamponade is relatively rare. Nearly half of all patients with chronic large pericardial effusion are asymptomatic.... (Review)
Review
Chronic massive pericardial effusion without cardiac tamponade is relatively rare. Nearly half of all patients with chronic large pericardial effusion are asymptomatic. We report a case of a 77-year-old man who presented with an asymptomatic chronic massive pericardial effusion, with no evidence of cardiac tamponade or pericardial constriction during a 10-year follow-up. The patient had a complex history of lymph node tuberculosis, hypertension, hypothyroidism, and polycythemia vera, as well as high-dose P radiation exposure 45 years ago. There was no evidence of tuberculosis infection, hypothyroidism, malignant tumor, severe heart failure, uremia, trauma, severe bacterial or fungal infection, chronic myeloid leukemia, or bone marrow fibrosis after admission. The patient underwent pericardiocentesis twice. The pericardial effusion comprised exudate fluid with a high proportion of monocytes. The patient refused indwelling catheter drainage or pericardiectomy. The likely final diagnosis was recurrent chronic large idiopathic pericardial effusion.
Topics: Aged; Cardiac Tamponade; Humans; Male; Pericardial Effusion; Pericardiectomy; Pericardiocentesis; Pericarditis
PubMed: 33233991
DOI: 10.1177/0300060520973091 -
Internal Medicine (Tokyo, Japan) Sep 2023
Topics: Humans; Cardiac Tamponade; Pericardial Effusion; Thymoma; Thymus Neoplasms
PubMed: 36642525
DOI: 10.2169/internalmedicine.1294-22 -
Interactive Cardiovascular and Thoracic... Jun 2022Isolated Chylopericardium (without chylothorax) is a rare clinical disorder that may happen idiopathically or secondary to trauma, radiotherapy, lymphatic anomalies,...
Isolated Chylopericardium (without chylothorax) is a rare clinical disorder that may happen idiopathically or secondary to trauma, radiotherapy, lymphatic anomalies, infections or mediastinal neoplasm. We present a case of middle-aged male with no past medical history of note prior to developing heavy sweating, loss of weight and cough. A series of investigations were done including chest computed tomography which showed enlarged mediastinal lymph nodes leading to uncomplicated mediastinoscopy and lymph node biopsy. Six days after being discharged, he developed dyspnoea and chest pain. Echocardiography revealed massive pericardial effusion. Pericardiocentesis was done and surprisingly revealed milky white chylous fluid. The patient was then successfully managed without the need for further intervention.
Topics: Chylothorax; Humans; Lymph Nodes; Male; Mediastinum; Middle Aged; Pericardial Effusion; Pericardiocentesis
PubMed: 34964452
DOI: 10.1093/icvts/ivab365 -
Multimedia Manual of Cardiothoracic... 2015Pericardial effusion may be associated with many diseases, but sometimes its aetiology is not easy to elucidate. Subxiphoid video-pericardioscopy is useful for the study...
Pericardial effusion may be associated with many diseases, but sometimes its aetiology is not easy to elucidate. Subxiphoid video-pericardioscopy is useful for the study of the pericardial cavity. Through a subxiphoid approach, the pericardium is incised and a rigid (usually a video-mediastinoscope) or a flexible endoscope (flexible bronchoscope or flexible choledoscope) is inserted into the pericardial cavity. The inner surface of the parietal pericardium and the epicardium can be explored and biopsies can be taken under visual control. In addition, a subxiphoid pericardial window can be developed, and sclerosing agents instilled for pericardiodesis, if a malignant aetiology is confirmed. In case of pericardial effusion associated with lung cancer, video-pericardioscopy helps to confirm the absence or presence of pericardial tumour implant or infiltration, and to establish the resectability of the tumour. Other than transient arrhythmias during the procedure, video-pericardioscopy has no major complications. When compared with surgical pericardial drainage, video-pericardioscopy has higher sensitivity without specific risks. Rigid endoscopes are the best devices to explore the posterior and lateral pericardial surfaces, the pulmonary veins being the posterior limit of the exploration. Big anterior mediastinal masses and pericardial symphysis may render the exploration impossible.
Topics: Endoscopy; Humans; Pericardial Effusion; Pericardial Window Techniques; Video-Assisted Surgery
PubMed: 26070990
DOI: 10.1093/mmcts/mmv009 -
Ugeskrift For Laeger May 2023Cholesterol pericarditis is an extremely rare type of pericarditis characterized by a continuous pericardial effusion containing high amounts of cholesterol crystals....
Cholesterol pericarditis is an extremely rare type of pericarditis characterized by a continuous pericardial effusion containing high amounts of cholesterol crystals. This case report of a 51-year-old male with syncopal episodes and a massive, cholesterol-rich pericardial effusion highlights the interdisciplinary approach and rationale in treating this rare condition of largely unknown pathogenesis.
Topics: Male; Humans; Middle Aged; Pericardial Effusion; Pericarditis; Cholesterol; Rare Diseases
PubMed: 37170745
DOI: No ID Found -
Clinical Cardiology Oct 2011Neoplastic pericardial effusion is a serious and common clinical disorder encountered by cardiologists, cardiothoracic surgeons, oncologists, and radiation oncologists.... (Review)
Review
Neoplastic pericardial effusion is a serious and common clinical disorder encountered by cardiologists, cardiothoracic surgeons, oncologists, and radiation oncologists. It may develop from direct extension or metastatic spread of the underlying malignancy, from an opportunistic infection, or from a complication of radiation therapy or chemotherapeutic toxicity. The clinical presentation varies, and the patient may be hemodynamically unstable in the setting of constrictive pericarditis and cardiac tamponade. The management depends on the patient's prognosis and varies from pericardiocentesis, sclerotherapy, and balloon pericardiotomy to cardiothoracic surgery. Patients with neoplastic pericardial effusion face a grave prognosis, as their malignancy is usually more advanced. This review article discusses the epidemiology and etiology, pathophysiology, clinical presentation, diagnosis, management, and prognosis of neoplastic pericardial effusion.
Topics: Hemodynamics; Humans; Neoplasms; Pericardial Effusion; Predictive Value of Tests; Prognosis; Risk Factors
PubMed: 21928406
DOI: 10.1002/clc.20936 -
Kardiologia Polska May 2020The aim of this review is to deal with management challenges related to diagnosis and therapy of noninfectious pericarditis. In the European countries in which a low... (Review)
Review
The aim of this review is to deal with management challenges related to diagnosis and therapy of noninfectious pericarditis. In the European countries in which a low prevalence of tuberculosis is noted, determining the etiology of pericarditis is essentially aimed at the exclusion of the most common causes, which may require a specific therapy and are associated with an increased risk of complications: systemic autoimmune or autoinflammatory diseases, postcardiac injury syndrome (5%-20%), neoplastic pericardial involvement (5%-10%), tuberculosis (about 5%), and rarely purulent pericarditis in less than 5% of cases. In developing countries that report a high prevalence of tuberculosis, this condition is the most common cause of pericardial diseases. The diagnosis is based on clinical criteria (pericarditis‑related chest pain and pericardial rubs) complemented by laboratory (elevated levels of C‑reactive protein) and imaging findings (electrocardiography, echocardiography, and other imaging modalities to provide evidence of pericardial inflammation in doubtful cases). Poor prognostic predictors (high fever >38 °C, subacute course, large pericardial effusion, cardiac tamponade, and lack of response to empiric anti‑inflammatory therapies) identify high‑risk patients who should be admitted to the hospital in order to determine disease etiology and receive appropriate treatment. The mainstay of medical therapy of noninfectious pericarditis is based on nonsteroidal anti‑inflammatory drugs and colchicine, with possible adjunct of corticosteroids at low‑to‑moderate doses in unresponsive patients. Additional therapies, particularly with anakinra, have been implemented for those who develop corticosteroid dependence and are colchicine‑resistant. Disease recurrence is the most common and troublesome complication of pericarditis, whereas the risk of developing constrictive pericarditis is related to the etiology and not to the number of recurrences.
Topics: Cardiologists; Europe; Humans; Pericardial Effusion; Pericarditis
PubMed: 32394692
DOI: 10.33963/KP.15353