1/316. Left ventricular apical diastolic collapse: an unusual echocardiographic marker of postoperative cardiac tamponade.A 37-year-old woman was evaluated for signs and symptoms of cardiac tamponade 11 days after mitral valve replacement and tricuspid valve repair. The transthoracic echocardiogram showed a large, compartmentalized pericardial effusion that resulted in left ventricular apical diastolic collapse. Also noted were right ventricular posterior wall diastolic collapse and hemodynamic findings consistent with cardiac tamponade. This case highlights the atypical echocardiographic findings in patients with pericardial effusions after cardiac surgery.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
2/316. Low cardiac output complicating pericardiectomy for pericardial tamponade.Neoplastic involvement of the pericardium resulting in an effusion and subsequent tamponade is an emergency requiring prompt decompression, generally safely accomplished by subxiphoid pericardiectomy. However, the current case report describes a patient with florid pericardial tamponade who underwent surgical decompression with transient hemodynamic improvement, who then rapidly developed progressive, heart failure and death. This paradoxical response to pericardial decompression, similar to that seen occasionally with pericardiectomy in constrictive pericarditis, may be more frequent than currently appreciated. Its cause may relate to the sudden removal of the chronic external ventricular support from the effusion resulting in ventricular dilatation and failure.- - - - - - - - - - ranking = 1keywords = effusion (Clic here for more details about this article) |
3/316. Subacute left ventricular free-wall rupture in early course of acute myocardial infarction. Clinical report of two cases and review of the literature.Left ventricular free wall rupture (LVFWR) may complicate an acute myocardial infarction (AMI); its frequency ranges from 1 to 6 percent. In the era of coronary care units, LVFWR is the second cause of in-hospital death, after pump failure. The subacute presentation accounts for 2-3 percent of total hospital admissions for AMI. heart rupture may not be suddenly fatal and sometimes there is enough time for surgical repair. Electromechanical dissociation is neither the only nor the main clinical presentation. More subtle symptoms occurring hours or days before the final event include unexplained hypotension and transient bradycardia and some ECG features such as persistent ST-segment elevation with T-waves failing to invert in the same leads. On echocardiographic subcostal view, pericardial effusion of more than 5-10 mm, with echo-dense masses overlying the heart independently of cardiac tamponade, is highly suggestive of heart rupture. If pericardiocentesis yields hemorrhagic fluid, surgical intervention is mandatory, providing both diagnostic confirmation and definitive treatment. Medical management strategies (prolonged bed rest, beta-blockade therapy) are still experimental but could become suitable for particular subsets of patients (elderly patients and patients at a high surgical risk). We report two cases of subacute LVFWR and review the currently available literature.- - - - - - - - - - ranking = 0.5keywords = effusion (Clic here for more details about this article) |
4/316. hypothyroidism presenting as acute cardiac tamponade with viral pericarditis.This report describes the case of a young woman who presented to an emergency department with severe abdominal pain and shock. The patient was found to have pericardial tamponade due to a massive pericardial effusion. On further evaluation, the etiology of this effusion was considered to be secondary to hypothyroidism with concominant acute viral pericarditis leading to a fulminant tamponade. The presentation, differential diagnosis, and management of pericardial effusion and tamponade secondary to hypothyroidism and viral pericarditis are discussed. The diagnosis of hypothyroidism in conjunction with acute viral pericarditis should be considered in patients presenting with unexplained pericardial effusion and tamponade.- - - - - - - - - - ranking = 2keywords = effusion (Clic here for more details about this article) |
5/316. Hemopericardium, anticoagulation, and an endocardial pacemaker. A case report with description of new auscultatory and radiographic signs.A case of organizing hemopericardium and cardiac tamponade in a patient with a permanent endocardial pacemaker who was maintained on anticoagulation is presented. The hemopericardium is concluded as solely due to the anticoagulation. A new auscultatory finding attributable to an endocardial pacemaker and a helpful radiographic sign of pericardial effusion in patients with these pacemakers is described.- - - - - - - - - - ranking = 0.5keywords = effusion (Clic here for more details about this article) |
6/316. cardiac tamponade in primary myxedema and review of the literature.A case of cardiac tamponade secondary to primary myxedema is described. The nature of the patient's pericardial fluid and clinical course compared with other cases in the literature is reviewed. The patient had no recurrence of cardiac tamponade. Complete resolution of the pericardial effusion occurred 10 months followint initial pericardiocentesis and L-thyroxine therapy.- - - - - - - - - - ranking = 0.5keywords = effusion (Clic here for more details about this article) |
7/316. survival without surgical repair of acute rupture of the right ventricular free wall.Rupture of the myocardial free wall is an infrequent complication of acute myocardial infarction. Unless it occurs in a space confined by pericardial adhesions, only surgical emergency repair of ruptured myocardium can prevent death. In this paper we report the case of an 81-year-old woman who was admitted to the emergency room with cardiac tamponade, resulting from inferolateral acute myocardial infarction and a subsequent rupture of the right ventricular free wall, with the formation of pericardial thrombus and effusion. The patient refused to undergo any surgical or invasive intervention, and therefore she was only treated conservatively. Nevertheless, her condition improved dramatically, as her blood pressure increased and echocardiography abnormalities almost disappeared. Follow-up echocardiography 7 months post discharge was unremarkable. We believe that this rare case emphasizes that in special circumstances, such as creation of a thrombus that prevents more blood from extravasating, free-wall rupture without surgical repair is compatible with long-term survival.- - - - - - - - - - ranking = 0.5keywords = effusion (Clic here for more details about this article) |
8/316. cardiac tamponade originating from primary gastric signet ring cell carcinoma.A 45-year-old man with dry cough and dyspnea was referred by a medical practitioner for evaluation of heart failure on February 10, 1996. Chest X-ray revealed increased cardiothoracic ratio, and ultrasonographic echocardiography disclosed massive pericardial effusion with right ventricular collapse. cardiac tamponade was diagnosed and pericardiocentesis was performed. Ten days after admission, the pleural effusion had become more pronounced, and thoracocentesis was performed. carcinoembryonic antigen level was elevated in both the pericardial and pleural effusion, and cytology implicated adenocarcinoma, which suggested malignant effusion. Endoscopic study disclosed gastric cancer in the posterior wall of the upper body, and the histopathological diagnosis was signet-ring cell carcinoma. The patient died of respiratory failure on May 2, 1996, and autopsy was performed. The final diagnosis was gastric cancer with pulmonary lymphangitis, pericarditis, and pleuritis carcinomatosa, accompanied by enlargement of mediastinal and paraaortic lymph nodes. Interestingly, the primary signet-ring cell carcinoma of the stomach was situated mostly in the mucosa. Deep in the submucosal region, there was prominent invasion of the intralymphatic vessels, without direct destruction of the mucosa muscularis.- - - - - - - - - - ranking = 2keywords = effusion (Clic here for more details about this article) |
9/316. Pericardial tamponade and massive pleural effusion complicating orthotopic heart transplantation.Pericardial and pleural effusions occur commonly after open cardiac procedures. However, the combination of tamponade and massive pleural effusion is not often observed. We present a case of such a patient who received an orthotopic heart transplant in a setting of previously diagnosed systemic sarcoidosis. Treatment ultimately required the creation of a pericardial window and chemical pleurodesis.- - - - - - - - - - ranking = 3keywords = effusion (Clic here for more details about this article) |
10/316. Benign thymoma presenting as symptomatic pericardial tamponade.Benign thymomas occasionally are complicated with pericardial effusion, but to our knowledge none has been reported with pericardial tamponade. We describe a man with pericardial tamponade in whom subsequent work-up revealed a benign thymoma.- - - - - - - - - - ranking = 0.5keywords = effusion (Clic here for more details about this article) |
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