1/134. Chronic eosinophilic pneumonia with pleural effusion.The case history of a 77-year-old lady with chronic eosinophilic pneumonia is presented. The diagnosis was difficult due to the simultaneous presence of a pleural effusion and congestive heart failure. Radiological findings and treatment are discussed.- - - - - - - - - - ranking = 1keywords = heart failure, heart (Clic here for more details about this article) |
2/134. 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 = 1.3092494943616keywords = heart, cardiac (Clic here for more details about this article) |
3/134. Prenatal features of noonan syndrome.We report six cases of noonan syndrome which presented prenatally with sonographic abnormalities. These included increased nuchal fluid, short femora, pleural effusions, hydrops, cardiac and renal abnormalities. A review of all cases of noonan syndrome seen at two regional genetics centres confirms the association with these sonographic abnormalities. These cases demonstrate the diversity of prenatal presentation of noonan syndrome and highlight the need to consider this diagnosis, particularly when faced with a fetus with a normal karyotype and varying degrees of oedema or hydrops, with a short femur length.- - - - - - - - - - ranking = 0.16722254963112keywords = cardiac (Clic here for more details about this article) |
4/134. An unusual procedure for the treatment of simultaneous pericardial and pleural effusions.BACKGROUND: Symptomatic posterior pericardial effusion (PE) represents a diagnostic challenge since it is not easy to quantify by echocardiography. In addition, this type of effusion is normally treated by surgery because of the difficulty in drainage. CASE: A 59-year-old male presented a symptomatic circumferential PE following mitral valve substitution. Two days after a successful percutaneous subcostal pericardiocentesis, he reported severe dyspnea with hypotension and pulsus paradoxus. At chest x-rays, he showed a left pleural effusion; echocardiography, also performed from the left posterior axillary line, showed a large posterior PE and a large pleural effusion separated by a membrane. A needle was inserted at the fourth intercostal space 2 cm medially to the left posterior axillary line and advanced into the pleural and then into the pericardial cavity under echocardiographic guidance. Serous-hemorrhagic fluid was drained from the pericardial (800 cc) cavity and, after retraction, from the left pleural cavities (600 cc), with consequent hemodynamic improvement. CONCLUSION: Pleuro-pericardiocentesis may represent a valid alternative to surgery for the treatment of cardiac tamponade due to posterior pericardial effusions, in the peculiar situation characterized by the simultaneous presence of a left pleural effusion. This procedure should be performed by qualified physicians under echographic guidance.- - - - - - - - - - ranking = 0.16722254963112keywords = cardiac (Clic here for more details about this article) |
5/134. Non-surgical treatment of purulent pericarditis, due to non-encapsulated haemophilus influenzae, in an immunocompromised patient.A 59-year-old woman suffering from rheumatoid arthritis was admitted with pleural empyema and pericarditis due to non-encapsulated H. influenzae, and developed signs of cardiac tamponade. Purulent pericarditis resolved after ultrasound-guided percutaneous aspiration and systemic antimicrobial therapy. Serial echocardiographic examinations showed a slowly vanishing effusion. Long term follow-up revealed no evidence of pericardial constriction. This case illustrates that life-threatening purulent pericarditis in an immunocompromised patient may respond well to non-surgical treatment.- - - - - - - - - - ranking = 0.16722254963112keywords = cardiac (Clic here for more details about this article) |
6/134. pulse methylprednisolone therapy for impending cardiac tamponade in immunoglobulin-resistant Kawasaki disease.We describe a boy with Kawasaki disease (KD) whose clinical course was marked by a rapid improvement upon treatment with intravenous immunoglobulin (IVIG) and oral aspirin, which - within 14 days - was followed by the development of a large pericardial effusion with symptoms of impending cardiac tamponade as part of a polyserositis syndrome (pleural effusions, ascites). Upon treatment with pulsed methylprednisolone, the pericardial and pleural effusions and ascites rapidly disappeared within 48 h. This is the first case reported with a polyserositis syndrome and impending cardiac tamponade during KD.- - - - - - - - - - ranking = 1.0033352977867keywords = cardiac (Clic here for more details about this article) |
7/134. Pulmonary alveolar-septal amyloidosis presenting as heart failure with unilateral pleural effusion: a case report.We report a case of pulmonary alveolar-septal amyloidosis associated with chylothorax and paraproteinemia initially presenting as congestive heart failure with unilateral pleural effusion. A 72-year-old man was initially diagnosed with congestive heart failure based on the correlation of clinical manifestation and chest radiography. Concentric left ventricular hypertrophy with mild hypokinesis of the left ventricle was found on cardiac echography. Thoracocentesis was performed for right-sided pleural effusion, which persisted despite medical treatment; chylous exudate was aspirated. Because the etiology of the exudative pleural effusion was undetermined, the patient underwent a thoracotomy that showed pulmonary alveolar-septal amyloidosis. immunoglobulin m paraproteinemia was identified by serum immunoelectrophoresis. We conclude that it is imperative to search for the cause of an undetermined exudative pleural effusion, with particular attention to chylothorax and amyloidosis as the differential diagnoses.- - - - - - - - - - ranking = 6.1672225496311keywords = heart failure, heart, cardiac (Clic here for more details about this article) |
8/134. Can pleural effusions cause cardiac tamponade?pleural effusion(s) can increase the pressure of an otherwise insignificant pericardial effusion to a degree that can result in cardiac tamponade. The case histories presented here illustrate the importance of recognizing this phenomenon and altering our treatment algorithm to drain the pleural effusions instead of the pericardial collections.- - - - - - - - - - ranking = 0.83611274815558keywords = cardiac (Clic here for more details about this article) |
9/134. Purulent pericarditis presenting as an extracardiac mass in a patient with untreated diabetes.A 50-year-old man with symptoms of bi-ventricular heart failure was transferred to our hospital with a diagnosis of extracardiac tumor. He had a 10 year history of untreated diabetes. Chest computed tomography (CT) revealed an extracardiac mass in the right atrio-ventricular groove. cardiac catheterization revealed an elevated mean right atrial pressure of 18 mmHg, mean pulmonary wedge pressure of 16 mmHg, and the right ventricular pressure curve demonstrated typical dips and plateaus. At surgery, there was severe adhesion between the pericardium and epicardium, and the pericardium was severely thickened and contained turbid pus. In the left thoracic cavity, there was large amount of pleural effusion and pus. Therefore, the patient was diagnosed with purulent pericarditis caused by left empyema. The thickened pericardium at the anterior portion of the heart was resected, however resection of the remaining portion was abandoned because the adhesion was so tight. After surgery, the patient underwent irrigation of the heart and left thoracic cavity by 1% povidone iodine solution and 0.5 mg/ml of imipenem for 7 days. Bacteriologic culture of the pus from the pericardium revealed anaerobic gram negative bacteria. After 4 months of antibiotics infusion, his C reactive protein became negative and the patient was subsequently discharged from our hospital.- - - - - - - - - - ranking = 2.4601460756789keywords = heart failure, heart, cardiac (Clic here for more details about this article) |
10/134. Use of intravenous immunoglobulins as an adjunct in the conservative management of chylothorax.Two children who developed chylothorax after surgery for congenital heart disease are presented. The conservative management of chylothorax is reviewed and the use of immunoglobulins in the treatment of sepsis is discussed. One patient survived.- - - - - - - - - - ranking = 0.22840538894609keywords = heart (Clic here for more details about this article) |
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