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Crombez J, Dewals W, Muiño Mosquera L, Martens T, Van Damme K, Bruyndonckx L. Spontaneous resolution of an intrapericardial thrombus as a complication of pericardiocentesis in a neonate. Cardiol Young 2024; 34:924-926. [PMID: 38250798 DOI: 10.1017/s1047951123004535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
We present the case of a premature neonate with pericardial effusion secondary to extravasation of total parenteral nutrition from a mispositioned/migrated umbilical venous catheter. Emergency pericardiocentesis was complicated by an intrapericardial thrombus, which was managed conservatively with spontaneous resolution within 24 hours. This case illustrates that the rare complication of an intrapericardial thrombus after pericardiocentesis can be successfully managed conservatively with close monitoring in haemodynamically stable paediatric patients.
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Affiliation(s)
- Joy Crombez
- Department of Neonatology, Antwerp University Hospital, Edegem, Belgium
| | - Wendy Dewals
- Department of Paediatric Cardiology, Antwerp University Hospital, Edegem, Belgium
| | | | - Thomas Martens
- Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium
| | - Karlijn Van Damme
- Department of Neonatology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium
| | - Luc Bruyndonckx
- Department of Paediatric Cardiology, Antwerp University Hospital, Edegem, Belgium
- Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium
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2
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Ono Y, Shinohara K, Ishida T, Yamada I, Kotani J. Migration of a pericardial drainage catheter into the right main pulmonary artery. Acute Med Surg 2024; 11:e968. [PMID: 38894734 PMCID: PMC11183183 DOI: 10.1002/ams2.968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/18/2024] [Accepted: 05/02/2024] [Indexed: 06/21/2024] Open
Abstract
Migration of a pericardial drainage catheter into the right main pulmonary artery. If clinical symptoms of cardiac tamponade are unresolved and dense hemorrhagic fluid is evacuated after pericardial drain placement, this rare but lethal complication is a possibility.
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Affiliation(s)
- Yuko Ono
- Department of Disaster and Emergency Medicine, Graduate School of MedicineKobe UniversityKobeJapan
- Department of Anesthesiology, Ohta General Hospital FoundationOhta Nishinouchi HospitalKoriyama City, FukushimaJapan
| | - Kauzaki Shinohara
- Department of Anesthesiology, Ohta General Hospital FoundationOhta Nishinouchi HospitalKoriyama City, FukushimaJapan
| | - Tokiya Ishida
- Department of Anesthesiology, Ohta General Hospital FoundationOhta Nishinouchi HospitalKoriyama City, FukushimaJapan
| | - Isamu Yamada
- Department of Disaster and Emergency Medicine, Graduate School of MedicineKobe UniversityKobeJapan
| | - Joji Kotani
- Department of Disaster and Emergency Medicine, Graduate School of MedicineKobe UniversityKobeJapan
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3
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Czech AA, Glaus TM, Testa F, Romito G, Baron Toaldo M. Clinical presentation, echocardiographic findings, treatment strategies, and prognosis of dogs with myxomatous mitral valve disease presented with pericardial effusion due to suspected left atrial tear: a retrospective case-control study. J Vet Cardiol 2023; 51:105-115. [PMID: 38128416 DOI: 10.1016/j.jvc.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION/OBJECTIVES Left atrial tear (LAT) is a life-threatening complication in dogs with myxomatous mitral valve disease (MMVD). The study objective was to describe clinical presentation, echocardiographic findings, treatment strategies, and survival in dogs with LAT compared to a control group of dogs with a similar stage of MMVD but no LAT. ANIMALS AND MATERIALS AND METHODS: two-center retrospective case-controlled study including 15 dogs with and 15 dogs without LAT was conducted. Clinical and echocardiographic data were reviewed, and survival information were collected. RESULTS Nine dogs in each group were in stage C of MMVD, while the remaining were in stage B2. No differences between groups were found regarding age, body weight, sex, kidney values, and echocardiography-derived cardiac dimensions. Most reported clinical signs associated with LAT included weakness, respiratory signs, and syncope. Treatment varied and was mainly focused on the management of congestive heart failure. Three dogs with LAT received a pericardiocentesis. All 15 dogs with LAT had died of cardiac causes, 5 dogs during the first 7 days after admission. The median survival time for all 15 dogs with LAT was 52 days compared to 336 days in the control group (P=0.103). When excluding 5 dogs with LAT that died during the first 7 days, the median survival increased to 407 days, not different compared to the control group (P=0.549). CONCLUSIONS Dogs with MMVD and LAT have a high short-term mortality; however, when surviving the acute phase, the long-term prognosis may not differ from dogs with a similarly advanced degree of MMVD but without LAT.
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Affiliation(s)
- A A Czech
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - F Testa
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - G Romito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy
| | - M Baron Toaldo
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland; Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Italy.
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4
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Hinkelbein J, Andres J, Böttiger BW, Brazzi L, De Robertis E, Einav S, Gwinnutt C, Kuvaki B, Krawczyk P, McEvoy MD, Mertens P, Moitra VK, Navarro-Martinez J, Nunnally ME, O'Connor M, Rall M, Ruetzler K, Schmitz J, Thies K, Tilsed J, Zago M, Afshari A. Cardiac arrest in the perioperative period: a consensus guideline for identification, treatment, and prevention from the European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery. Eur J Anaesthesiol 2023; 40:724-736. [PMID: 37218626 DOI: 10.1097/eja.0000000000001813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resuscitation Council (ERC) guidelines. MATERIAL AND METHODS The European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery jointly nominated a panel of experts to develop guidelines for the recognition, treatment and prevention of cardiac arrest in the perioperative period. A literature search was conducted in MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. All searches were restricted to publications from 1980 to 2019 inclusive and to the English, French, Italian and Spanish languages. The authors also contributed individual, independent literature searches. RESULTS This guideline contains background information and recommendation for the treatment of cardiac arrest in the operating room environment, and addresses controversial topics such as open chest cardiac massage (OCCM), resuscitative endovascular balloon occlusion (REBOA) and resuscitative thoracotomy, pericardiocentesis, needle decompression and thoracostomy. CONCLUSION Successful prevention and management of cardiac arrest during anaesthesia and surgery requires anticipation, early recognition and a clear treatment plan. The ready availability of expert staff and equipment must also be taken into consideration. Success not only depends on medical knowledge, technical skills and a well organised team using crew resource management but also on an institutional safety culture embedded in everyday practice through continuous education, training and multidisciplinary co-operation.
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Affiliation(s)
- Jochen Hinkelbein
- From the University Department of Anaesthesiology, Intensive Care Medicine and Emergency Medicine, Johannes Wesling Klinikum Minden, University Hospital Ruhr-University Bochum, Minden, Germany (JH), Department of Anaesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany (BWB, JS), Department of Anaesthesiology and Intensive Therapy, Jagiellonian University Medical College, Krakow, Poland (JA), Department of Surgical Sciences, University of Turin, Turin (LB), Division of Anaesthesia, Analgesia and Intensive Care, Department of Medicine and Surgery, University of Perugia, Italy (EdR), Intensive Care Unit, Shaare Zedek Medical Center and Hebrew University Faculty of Medicine, Jerusalem, Israel (SE), Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK (CG), Department of Anesthesiology and Reanimation, Dokuz Eylül University, İzmir, Turkey (BK), Department of Anesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Krakow, Poland (PK), Department of Anaesthesiology, Antwerp University Hospital, Edegem, Belgium (PM), Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee (MDM), Division of Critical Care Anesthesiology, Department of Anesthesiology, Columbia University, New York, USA (VKM), Anesthesiology Department, Dr Balmis General University Hospital, Alicante Institute for Health and Biomedical Research (ISAB), and Biomedical Research (ISABIAL), Alicante, Spain (JN-M), Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York (MEN), Department of Anesthesiology & Critical Care, University of Chicago, Illinois, USA (MO'C), Institute for Patient Safety and Simulation Team Training InPASS, Reutlingen, Germany (MR), Departments of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA (KR), Department of Anaesthesiology and Critical Care, EvKB, OWL University Medical Center, Bielefeld University, Campus Bielefeld-Bethel, Germany (KT), Department of Surgery, Hull University Teaching Hospitals, Hull, UK (JT), General & Emergency Surgery Division, Department of Surgery, A. Manzoni Hospital, Milan, Italy (MZ) and Department of Paediatric and Obstetric Anaesthesia, Juliane Marie Centre, Rigshospitalet, Denmark and Department of Clinical Medicine, University of Copenhagen, Denmark (AA)
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Harfouch B, Garcia M, Tolan S, Mantha Y, Hammadah M, Chilton R, Prasad A. Coronary Artery Perforation: A Rare Serious Complication of Pericardiocentesis. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2022; 1:100409. [PMID: 39131474 PMCID: PMC11308111 DOI: 10.1016/j.jscai.2022.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/06/2022] [Accepted: 06/27/2022] [Indexed: 08/13/2024]
Affiliation(s)
- Badr Harfouch
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
| | - Marlene Garcia
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
| | - Scott Tolan
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
| | - Yogamaya Mantha
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
| | - Muhammed Hammadah
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
| | - Robert Chilton
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
| | - Anand Prasad
- Department of Medicine, Division of Cardiology, UT Health San Antonio, San Antonio, Texas
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6
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Beausoleil C, Comstock SL, Werner D, Li L, Eby JM, Zook EC. Antimicrobial persistence of two alcoholic preoperative skin preparation solutions. J Hosp Infect 2022; 129:8-16. [PMID: 36049573 DOI: 10.1016/j.jhin.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/08/2022] [Accepted: 08/17/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Normal skin flora and suboptimal skin antisepsis are the primary drivers of healthcare-associated infections (HAIs). Antimicrobial persistence of preoperative skin preparation is necessary to limit microorganisms on the skin and help minimize their entry into an incision or device-insertion site after application. AIM To assess the antimicrobial persistence of two preoperative skin preparation solutions. METHODS A randomized, single-centre, partially blinded, clinical study was conducted in 103 healthy volunteers to evaluate the persistent antimicrobial properties of BD ChloraPrep™ (2% w/v chlorhexidine gluconate [CHG] + 70% v/v isopropyl alcohol [IPA]) and BD PurPrep™ (8.3% w/w povidone-iodine [PVP-I] + 72.5% w/w IPA) skin preparations out to 7 days and 96 hours, respectively, on abdomen and groin testing sites. An additional 32 healthy volunteers participated in a neutralization procedure to ensure the study recovery solution was non-toxic to microorganisms, and a spore-recovery procedure to demonstrate that microorganisms could be successfully recovered from the PVP-I+IPA film-forming product. RESULTS Both CHG+IPA and PVP-I+IPA produced a mean bacterial log10 reduction >2 and >3 on the abdomen and groin, respectively, 10 minutes after application. CHG+IPA maintained antimicrobial persistence out to 7 days post-application, while PVP-I+IPA maintained antimicrobial persistence out to 96 hours post-application, the longest timepoint selected for this product. CONCLUSION CHG+IPA and PVP-I+IPA were both found to be effective persistent antiseptic skin preparations. Overall, skin irritation was uncommon, and only 1 adverse event occurred following product application, which was not considered product related but was considered procedure related.
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Affiliation(s)
| | | | - Donna Werner
- Becton, Dickinson and Company; 75 N. Fairway Dr., Vernon Hills, IL 60061, USA
| | - Lingzhi Li
- Becton, Dickinson and Company; 75 N. Fairway Dr., Vernon Hills, IL 60061, USA
| | - Jonathan M Eby
- Becton, Dickinson and Company; 75 N. Fairway Dr., Vernon Hills, IL 60061, USA
| | - Erin C Zook
- Becton, Dickinson and Company; 75 N. Fairway Dr., Vernon Hills, IL 60061, USA.
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7
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Adi O, Fong CP, Ahmad AH, Panebianco N. Worsening cardiac tamponade after pericardiocentesis in a patient with anterior mediastinum mass: a case report. Eur Heart J Case Rep 2022; 6:ytac329. [PMID: 36004046 PMCID: PMC9395134 DOI: 10.1093/ehjcr/ytac329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/25/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022]
Abstract
Background Mediastinal mass is an entity with variable pathology and clinical spectrum. Anterior mediastinal mass can result in severe symptoms due to involvement of surrounding vital structures such as the great vessels, trachea-bronchial tree, and heart. We highlight a case of cardiac tamponade in a patient with an anterior mediastinal mass that was paradoxically worsened after decompressive pericardiocentesis. Case summary A 21-year-old male presented to the emergency department (ED) with breathlessness and hypotension. Bedside focused cardiac ultrasound revealed cardiac tamponade which was made worse with an anterior mediastinal mass compressing the right heart chambers. The patient was intubated for respiratory failure, following which an ultrasound-guided pericardiocentesis was performed. Unexpectedly, his hemodynamic status worsened after aspiration of 1000 mL of pericardial fluid. A repeat focused cardiac ultrasound showed reduced pericardial effusion, but worsening of right heart chambers compression by the mediastinal mass. Re-expansion of the pericardium space with 600 mL of normal saline improved the patient’s vital signs, and reduced the right heart compression. Computed tomography was deferred due to the patient’s hemodynamic instability. Despite resuscitation with fluids and initiation of vasopressor, the patient’s condition deteriorated. He succumbed to his illness due to obstructive shock causing multi-organ failure. The autopsy showed a large anterior mediastinal mass, and histopathological examination confirmed the diagnosis of lymphoma. Discussion This case demonstrated the therapeutic challenges of managing a shock patient with anterior mediastinal mass, and massive pericardial effusion causing cardiac tamponade.
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Affiliation(s)
- Osman Adi
- Department, Hospital Raja Permaisuri Bainun , Ipoh, PRK , Malaysia
| | - Chan Pei Fong
- Department, Hospital Raja Permaisuri Bainun , Ipoh, PRK , Malaysia
| | | | - Nova Panebianco
- Department of Emergency Medicine, Hospital of the University of Pennsylvania , Philadelphia, PA , USA
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8
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Krishnan S, Park JH, Siddiqui N, Halabi AR, Ahluwalia G, Desai RG, Patel KM. "The Pericardial Effusion is Drained, But the Catheter Is Stuck"-Percutaneous Evacuation of Pericardial Effusion Complicated by Pigtail Catheter Entrapment in Fibrinous Pericarditis. J Cardiothorac Vasc Anesth 2022; 36:3216-3220. [PMID: 35469716 DOI: 10.1053/j.jvca.2022.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Sandeep Krishnan
- Department of Anesthesiology, Wayne State University School of Medicine, Detroit, MI; Department of Anesthesiology, St. Joseph Mercy Oakland Hospital, Pontiac, MI.
| | - Jee Ha Park
- Department of Anesthesiology, Wayne State University School of Medicine, Detroit, MI
| | - Nazia Siddiqui
- Department of Anesthesiology, Wayne State University School of Medicine, Detroit, MI
| | - Abdul R Halabi
- Department of Cardiology, St. Joseph Mercy Oakland Hospital, Pontiac, MI
| | - Guneet Ahluwalia
- Department of Cardiology, St. Joseph Mercy Oakland Hospital, Pontiac, MI
| | - Ronak G Desai
- Department of Anesthesiology, Cooper University Healthcare, Camden, NJ
| | - Kinjal M Patel
- Department of Anesthesiology, Cooper University Healthcare, Camden, NJ
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9
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Rosmini S, Seraphim A, Knott K, Brown JT, Knight DS, Zaman S, Cole G, Sado D, Captur G, Gomes AC, Zemrak F, Treibel TA, Cash L, Culotta V, O’Mahony C, Kellman P, Moon JC, Manisty C. Non-invasive characterization of pleural and pericardial effusions using T1 mapping by magnetic resonance imaging. Eur Heart J Cardiovasc Imaging 2022; 23:1117-1126. [PMID: 34331054 PMCID: PMC9612798 DOI: 10.1093/ehjci/jeab128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
AIMS Differentiating exudative from transudative effusions is clinically important and is currently performed via biochemical analysis of invasively obtained samples using Light's criteria. Diagnostic performance is however limited. Biochemical composition can be measured with T1 mapping using cardiovascular magnetic resonance (CMR) and hence may offer diagnostic utility for assessment of effusions. METHODS AND RESULTS A phantom consisting of serially diluted human albumin solutions (25-200 g/L) was constructed and scanned at 1.5 T to derive the relationship between fluid T1 values and fluid albumin concentration. Native T1 values of pleural and pericardial effusions from 86 patients undergoing clinical CMR studies retrospectively analysed at four tertiary centres. Effusions were classified using Light's criteria where biochemical data was available (n = 55) or clinically in decompensated heart failure patients with presumed transudative effusions (n = 31). Fluid T1 and protein values were inversely correlated both in the phantom (r = -0.992) and clinical samples (r = -0.663, P < 0.0001). T1 values were lower in exudative compared to transudative pleural (3252 ± 207 ms vs. 3596 ± 213 ms, P < 0.0001) and pericardial (2749 ± 373 ms vs. 3337 ± 245 ms, P < 0.0001) effusions. The diagnostic accuracy of T1 mapping for detecting transudates was very good for pleural and excellent for pericardial effusions, respectively [area under the curve 0.88, (95% CI 0.764-0.996), P = 0.001, 79% sensitivity, 89% specificity, and 0.93, (95% CI 0.855-1.000), P < 0.0001, 95% sensitivity; 81% specificity]. CONCLUSION Native T1 values of effusions measured using CMR correlate well with protein concentrations and may be helpful for discriminating between transudates and exudates. This may help focus the requirement for invasive diagnostic sampling, avoiding unnecessary intervention in patients with unequivocal transudative effusions.
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Affiliation(s)
- Stefania Rosmini
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
- King’s College Hospital NHS Trust Foundation, Denmark Hill, London SE5 9RS, UK
| | - Andreas Seraphim
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Kristopher Knott
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - James T Brown
- Royal Free London NHS Foundation Trust, Pond St, London NW3 2QG, UK
| | - Daniel S Knight
- Royal Free London NHS Foundation Trust, Pond St, London NW3 2QG, UK
| | - Sameer Zaman
- Imperial College London, Imperial College, Healthcare NHS Trust, South Kensington, London SW7 2BX, UK
| | - Graham Cole
- Imperial College London, Imperial College, Healthcare NHS Trust, South Kensington, London SW7 2BX, UK
| | - Daniel Sado
- King’s College Hospital NHS Trust Foundation, Denmark Hill, London SE5 9RS, UK
| | - Gabriella Captur
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
- Institute for Cardiovascular Sciences, University College London, 62 Huntley St, London WC1E 6DD, UK
| | - Ana Caterina Gomes
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Filip Zemrak
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Thomas A Treibel
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Lizette Cash
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Veronica Culotta
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Constantinos O’Mahony
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
| | - Peter Kellman
- National Heart, Lung and Blood Institute, National Institutes of Health, Medical Signal and Imaging Processing Program, 10 Center Dr, Bethesda, MD 20814, USA
| | - James C Moon
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
- Institute for Cardiovascular Sciences, University College London, 62 Huntley St, London WC1E 6DD, UK
| | - Charlotte Manisty
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew’s Hospital, King George V Building, West Smithfield, London EC1A 7BE, UK
- Institute for Cardiovascular Sciences, University College London, 62 Huntley St, London WC1E 6DD, UK
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10
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SUNKAK S, ARGUN M. Three years of interventional pediatric cardiology experience in a newly built city hospital. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1124163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The importance of interventional methods in the treatment of congenital heart disease (CHD) is increasing. In this article, we retrospectively evaluated our angiography experience for the diagnosis and treatment of congenital heart diseases in the newly built Kayseri City Hospital for 3 years.
Material and Method: The demographic data of the patients, their diagnoses and information about interventions were evaluated retrospectively.
Results: In our center, 291 interventional procedures were performed in a 36-month period. 71 (24%) procedures were for diagnostic evaluation and 220 (76%) procedures were for treatment. 74 (25%) atrial septal defect (ASD) closure procedures, 9 (3%) ventricular septal defect (VSD) closure procedures and 62 (21.3%) patent ductus arteriosus (PDA) closure procedures were performed via percutaneous technique. Eleven of the patients who underwent PDA closure were
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Affiliation(s)
- Süleyman SUNKAK
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
| | - Mustafa ARGUN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, KAYSERİ TIP FAKÜLTESİ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANA BİLİM DALI, ÇOCUK KARDİYOLOJİSİ
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11
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Herren JL, Chan H, Ray CE. Pericardial Drain Placement in Interventional Radiology: An Overview. Semin Intervent Radiol 2022; 39:271-274. [PMID: 36062234 PMCID: PMC9433152 DOI: 10.1055/s-0042-1753523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Pericardial effusions can occur from multiple different etiologies. Although often incidentally noted or clinically silent, pericardial effusions may cause significant hemodynamic compromise. In some of these patients, pericardiocentesis may be temporizing only and either repeat procedures or placement of pericardial drains may be preferable. While cardiologists typically perform pericardial drain placement, it is a procedure that may also be performed by interventional radiologists. This article describes for the interventional radiologist the indications and placement technique, as well as potential complications occurring from pericardial drain placement.
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Affiliation(s)
- Josi L. Herren
- Department of Radiology, University of Illinois College of Medicine, Chicago, Illinois
| | - HingKui Chan
- Department of Radiology, University of Illinois College of Medicine, Chicago, Illinois
| | - Charles E. Ray
- Department of Radiology, University of Illinois College of Medicine, Chicago, Illinois
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12
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Sugiyama K, Tanabe S, Watanuki H, Tochii M, Futamura Y, Makino S, Matsuyama K. Free‐wall perforation of the left ventricle after acute myocardial infarction complicated with pericardial tamponade that mimicked ascending aortic dissection: A case report. Clin Case Rep 2022; 10:e05871. [PMID: 35600038 PMCID: PMC9117708 DOI: 10.1002/ccr3.5871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/06/2022] [Accepted: 03/28/2022] [Indexed: 11/18/2022] Open
Abstract
Life‐threatening cardiac events may be misdiagnosed as acute aortic dissection because of notable symptom mimicry. We report the case of a 72‐year‐old male patient with presentations presumed to be of aortic origin. However, surgery revealed posterior free‐wall perforation in the left ventricle caused by the occlusion of an obtuse marginal branch.
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Affiliation(s)
- Kayo Sugiyama
- Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan
| | - Subaru Tanabe
- Department of Emergency Aichi Medical University Hospital Nagakute Japan
| | - Hirotaka Watanuki
- Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan
| | - Masato Tochii
- Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan
| | - Yasuhiro Futamura
- Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan
| | - Satoshi Makino
- Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan
| | - Katsuhiko Matsuyama
- Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan
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13
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Bhutani J, Batra A, Gupta A, Gupta A, Mahajan K. Transient left ventricular dysfunction after therapeutic pericardiocentesis - Takotsubo cardiomyopathy or pericardial decompression syndrome. Monaldi Arch Chest Dis 2022; 92. [DOI: 10.4081/monaldi.2022.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
We present a case of reversible left ventricular (LV) dysfunction with characteristic stress or "Takotsubo" cardiomyopathy (SCM) after therapeutic pericardiocentesis in a patient with tubercular pericardial effusion. SCM following pericardiocentesis is uncommon, as opposed to the well-defined entity, pericardial decompression syndrome (PDS). PDS is defined as a paradoxical deterioration of hemodynamics and development of severe biventricular dysfunction, cardiogenic shock, and pulmonary edema after uneventful, often large volume pericardiocentesis in patients of pericardial effusion.
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14
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Acute Marginal Artery Laceration as a Complication of Pericardiocentesis. JACC Case Rep 2022; 4:501-504. [PMID: 35493792 PMCID: PMC9044294 DOI: 10.1016/j.jaccas.2022.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 11/21/2022]
Abstract
The safety of pericardiocentesis as a therapy for cardiac tamponade has improved since the advent of echocardiography-guided pericardiocentesis. The most life-threatening, albeit rare, complication is injury to the coronary vessels or ventricular wall resulting in recurrent tamponade. We present a rare case of acute marginal artery laceration resulting from pericardiocentesis. (Level of Difficulty: Beginner.)
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15
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Iwasaki YK, Fujimoto Y, Ito-Hagiwara K, Oka E, Hayashi H, Kubota Y, Murata H, Yamamoto T, Miyachi H, Tara S, Tokita Y, Yodogawa K, Yamamoto T, Takano H, Shimizu W. Feasibility and safety of CT-aided pericardiocentesis from a subxiphoid anterior approach by using fluoroscopy in patients with chronic pericardial effusions. Clin Cardiol 2022; 45:519-526. [PMID: 35266157 PMCID: PMC9045084 DOI: 10.1002/clc.23810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Pericardiocentesis is an essential procedure for the diagnosis and treatment of pericardial effusions. The purpose of this study was to evaluate the feasibility and safety of a subxiphoid anterior approach using fluoroscopy aided by a sagittal axis chest computed tomography (CT) view in comparison with an ultrasound‐guided apical approach in patients with chronic pericardial effusion. Methods Among 72 consecutive patients (68.8 ± 14.4 years old, 52 males) with hemodynamically stable chronic pericardial effusions, a total of 85 procedures were retrospectively analyzed. We divided them into two groups according to the site of the approach for the pericardiocentesis. Results A subxiphoid anterior approach (n = 53) was performed guided by fluoroscopy. The sagittal axis view of the chest CT was constructed to determine the puncture angle and direction for the subxiphoid anterior approach. An apical approach (n = 32) was performed by ultrasound guidance. The success rates of the anterior and apical approaches were 98.1% and 93.8%, respectively. There were two cases with cardiac perforations in the apical approach group, while no cases developed perforations in the subxiphoid anterior approach group. Conclusion The subxiphoid anterior approach for pericardiocentesis was feasible and safe for managing chronic pericardial effusions. A reconstruction of the sagittal axis view of the chest CT imaging was helpful to identify the direction and depth to access the pericardial space from the subxiphoid puncture site before the pericardiocentesis using the lateral fluoroscopic view.
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Affiliation(s)
- Yu-Ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yuhi Fujimoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | | | - Eiichiro Oka
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshiaki Kubota
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroshige Murata
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Teppei Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hideki Miyachi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Shuhei Tara
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yukichi Tokita
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Takeshi Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hitoshi Takano
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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16
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Ajay A, Jineesh V, Anoop A, Kannath S, Kramadhari H. Pericardial Tamponade during Supra Hepatic IVC Angioplasty in Budd-Chiari Syndrome Managed by Ultrasound-Guided Pericardiocentesis. JOURNAL OF CLINICAL INTERVENTIONAL RADIOLOGY ISVIR 2022. [DOI: 10.1055/s-0041-1742230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Alex Ajay
- Department of Imaging sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Valakkada Jineesh
- Department of Imaging sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Ayyappan Anoop
- Department of Imaging sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Santhosh Kannath
- Department of Imaging sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Harshit Kramadhari
- Department of Imaging sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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17
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Singal AK, Bansal R, Pandey NN, Ramakrishnan S. Percutaneous Management of an Iatrogenic Inferior Vena Cava Rent Secondary to Erroneous Pericardiocentesis. JACC Cardiovasc Interv 2021; 14:2632-2634. [PMID: 34774479 DOI: 10.1016/j.jcin.2021.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Aayush K Singal
- Department of Cardiology, Cardio Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India. https://twitter.com/Singal_Aayush
| | - Raghav Bansal
- Department of Cardiology, Cardio Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India.
| | - Niraj Nirmal Pandey
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
| | - Sivasubramanian Ramakrishnan
- Department of Cardiology, Cardio Thoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India
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18
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Outcomes of Patients with and without Malignancy Undergoing Percutaneous Pericardiocentesis for Pericardial Effusion. J Cardiovasc Dev Dis 2021; 8:jcdd8110150. [PMID: 34821703 PMCID: PMC8618840 DOI: 10.3390/jcdd8110150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: This study aimed to evaluate the etiologies and clinical outcomes of patients with pericardial effusion (PE) treated with echo-guided percutaneous pericardiocentesis. (2) Methods: Between July 2010 and December 2020, a total of 502 patients underwent echo-guided percutaneous pericardiocentesis for PE at our hospital. The reasons for PE were malignancy (N = 277), and non-malignancy (N = 225). The comorbidities, complications, and all-cause mortality were compared between the malignancy and non-malignancy groups. (3) Results: In multivariable Cox regression analyses for 1-year mortality, malignancy related PE, nasopharyngeal and oropharyngeal cancer, and metastatic status were positive predictors. A higher incidence of in-hospital and 1-year mortality were observed in patients with malignancy-related PE than with non-malignancy-related PE. In patients with malignancy-related PE, the Kaplan-Meier curve of 1-year all-cause mortality significantly differed between patients with or without metastasis; however, PE with or without malignant cells did not influence the prognosis. (4) Conclusions: In the patients with large PE requiring percutaneous pericardiocentesis, malignancy-related PE, nasopharyngeal and oropharyngeal cancer, and metastatic status were positive predictors of 1-year mortality. In patients with malignancy, a higher incidence of all-cause mortality was noted in patients with metastasis but did not differ between the groups with and without malignant cells in PE.
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19
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Curiale A, Vallabhaneni S, Longo S, Shirani J. Massive left ventricular thrombosis in pericardial decompression syndrome. Echocardiography 2021; 38:1471-1473. [PMID: 34286874 DOI: 10.1111/echo.15151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/11/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Pericardial decompression syndrome (PDS) is defined as paradoxical hemodynamic deterioration associated with left, right, or bi-ventricular dilation and systolic dysfunction following pericardiocentesis. It is uncommon yet under-recognized, underreported, and associated with significant morbidity and mortality. CASE REPORT We report a unique case of PDS associated with left ventricular (LV) systolic dysfunction and massive apical thrombosis following surgical removal of 800 ml of pericardial fluid in a 72-year-old man with undiagnosed lung cancer. Treatment with anticoagulation and anti-remodeling medications resulted in complete resolution of the thrombus and recovery of LV function. CONCLUSIONS PDS, although rare, can lead to significant morbidity and mortality. Left ventricular apical thrombosis could result from PDS in the setting of hypercoagulable state. Treatment of the underlying disease may lead to successful resolution of PDS and its complications.
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Affiliation(s)
- Andrew Curiale
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Srilakshmi Vallabhaneni
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Santo Longo
- Department of Pathology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Jamshid Shirani
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
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20
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Therapeutic Computed Tomography-Guided Pericardiocentesis: Lessons Learned Based on a 7-Year Single-Center Experience. J Comput Assist Tomogr 2021; 45:643-648. [PMID: 34270484 DOI: 10.1097/rct.0000000000001190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Pericardiocentesis is a well-known procedure commonly performed by either image-guided intervention or surgical approaches. Computed tomography (CT)-guided pericardiocentesis is not widely used, but provides certain advantages. In the article we will discuss our technique of CT-guided therapeutic pericardiocentesis, including advantages and disadvantages, patient selection, possible approaches, and complications. METHODS The retrospective study included 121 therapeutic pericardial drainages performed under CT guidance. Demographic data of the patients, entry site, and needle orientation were recorded. Procedure complications and their significance were analyzed. RESULTS One hundred and twenty-one pericardial drainages with catheter insertion were performed under CT guidance on 119 patients presenting with clinically significant pericardial effusion. The most common approach was at the left anterior chest wall. The rate of minor complications was 5.8%, no major complications occurred. CONCLUSIONS Therapeutic pericardiocentesis can be obtained under CT guidance in a safe and effective manner. Recommendations for building a patient-centered protocol with an interdisciplinary team are discussed. Patient selection, procedural guidance, and lessons to avoid complications are reviewed.
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21
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Mohamed A, Christopher N, Philpotts YF, Leibner ES. A Spontaneously Resolving Pericardial Effusion During CPR. Chest 2021; 157:e177-e180. [PMID: 32386653 DOI: 10.1016/j.chest.2019.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/01/2019] [Accepted: 07/18/2019] [Indexed: 10/24/2022] Open
Affiliation(s)
- Amira Mohamed
- Institute of Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Neil Christopher
- Institute of Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yoland F Philpotts
- Institute of Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Evan S Leibner
- Institute of Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
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22
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Wilson NR, Lee MT, Gill CD, Serauto Canache A, Donisan T, Balanescu DV, Song J, Palaskas N, Lopez-Mattei J, Cilingiroglu M, Marmagkiolis K, Iliescu CA. Prognostic Factors and Overall Survival After Pericardiocentesis in Patients With Cancer and Thrombocytopenia. Front Cardiovasc Med 2021; 8:638943. [PMID: 33969007 PMCID: PMC8096910 DOI: 10.3389/fcvm.2021.638943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pericardiocentesis is an important diagnostic and therapeutic tool for cancer-associated pericardial effusion. Limited safety and outcomes data exists regarding the management of malignancy-related pericardial effusion in patients with thrombocytopenia. Objectives: Our study aimed to analyze prognostic factors and overall survival (OS) after pericardiocentesis in thrombocytopenic cancer patients. Methods and Results: A retrospective review of 136 thrombocytopenic cancer patients who underwent primary percutaneous pericardiocentesis was performed. Degree of thrombocytopenia was classified by platelet count recorded on day of pericardiocentesis: 75–149 × 103 cells/μL (41%); 50–74 × 103 cells/μL (10%); 25–49 × 103 cells/μL (24%); <25 × 103 cells/μL (25%). Median OS was 2.6 months and median follow-up was 37.4 months. Kaplan-Meier survival analysis showed significant OS differences among thrombocytopenia severity groups (p = 0.023), and worse OS with platelets <100 vs. ≥100 × 103 cells/μL (p = 0.031). By univariate analysis, thrombocytopenia severity was associated with increased risk of death (HR 0.993; 95% CI 0.989–0.997; p = 0.002). Poor prognostic factors for OS were advanced cancer, malignant effusion, elevated international normalized ratio (INR), quantity of platelet transfusions, and platelet transfusion resistance. However, thrombocytopenia severity became insignificant for OS (p = 0.802), after adjusting for advanced cancer and INR. Conclusions: For patients with malignancy-related large pericardial effusion and thrombocytopenia, pericardiocentesis is a feasible intervention and should be considered due to low complication rates. There is no absolute contraindication to pericardiocentesis in case of hemodynamic instability, even with severe thrombocytopenia.
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Affiliation(s)
- Nathaniel R Wilson
- Division of Cardiology, Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, United States
| | - Michelle T Lee
- Division of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Clarence D Gill
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Astrid Serauto Canache
- Division of Cardiology, Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, United States
| | - Teodora Donisan
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Dinu V Balanescu
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Juhee Song
- Division of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Nicolas Palaskas
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Juan Lopez-Mattei
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Mehmet Cilingiroglu
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Konstantinos Marmagkiolis
- Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Cezar A Iliescu
- Division of Cardiology, Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, United States.,Division of Cardiology, Department of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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23
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Case study-based systematic review of literature on lymphoma-associated cardiac tamponade. Contemp Oncol (Pozn) 2021; 25:57-63. [PMID: 33911983 PMCID: PMC8063898 DOI: 10.5114/wo.2021.103828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/03/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to compile all the relevant studies of patients presenting with pericardial tamponade before or after diagnosis of lymphoma, describe the clinical presentations of patients with lymphoma and cardiac tamponade, and assess the difference in overall survival based on the timing of cardiac tamponade diagnosis. A comprehensive search strategy was conducted in the following databases: PubMed and Cochrane Library, using the following keywords: Lymphoma AND Cardiac Tamponade. The criteria for eligibility included cases with a confirmed diagnosis of lymphoma and cardiac tamponade, human studies, and publications in English language. The statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) version 20. We included 48 research articles (n = 52 cases) with adequate reporting of measured outcomes. The median age of the patients was 52 (9–94) years. Only 6 patients were noted to have primary cardiac lymphoma, while the majority of cases were considered to have secondary cardiac lymphoma (88.5%). According to the data on the type of lymphoma reported through cytology and immunohistochemistry, 49 patients were diagnosed with non-Hodgkin lymphoma, and of these cases the most common subtype was large B-cell lymphoma (42.9%). Overall, the average duration of illness was 14 ± 23 days. A total of 13 patients had distant heart sounds, 12 cases were noted to be hypotensive, and 13 subjects were found to have increased jugular venous pressure. Our retrospective study demonstrated that most patients presented with pericardial tamponade after lymphoma diagnosis, and those were mostly secondary cardiac lymphoma of the non-Hodgkin type with large B-cell as the most common subtype. Dyspnoea, oedema, and constitutional symptoms were the most common presenting signs. The median overall survival of patients with lymphoma and cardiac tamponade is 4 months, with no significant difference in mortality in the presentation timing before and after the diagnosis of lymphoma.
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24
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Palma A, Henriques C, Silva PV, Pires A. Pneumopericardium and pleural effusion: a rare complication of paediatric pericardiocentesis. BMJ Case Rep 2020; 13:e236308. [PMID: 33148574 PMCID: PMC7640467 DOI: 10.1136/bcr-2020-236308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2020] [Indexed: 11/03/2022] Open
Abstract
Pneumopericardium is a rare complication of pericardiocentesis (PC), occurring as a result of either a direct pleuropericardial communication or a leaky drainage system. Pneumopericardium is often self-limiting; however, physicians should be aware of this complication as it may progress to tension pneumopericardium, which requires immediate recognition and management. PC has been associated with pneumothorax, pneumomediastinum or subcutaneous emphysema, but the association with pleural effusion has been less reported. The authors present the case of a 14-year-old healthy boy who developed post-PC pneumopericardium and pleural effusion, a rare association reported in the literature. The diagnosis of this potential life-threatening event was made using readily available complementary diagnostic methods, such as transthoracic echocardiography and chest X-ray.
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Affiliation(s)
- Andreia Palma
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Claudio Henriques
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Patrícia Vaz Silva
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - António Pires
- Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
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25
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Cerrud-Rodriguez RC, Rashid SMI, Shaqra H, Alkhalil A, Algodi M, Chudow JJ, Garcia MJ, Tauras JM, Weisz G. An Overlap Presentation of Pericardial Decompression Syndrome and Stress Cardiomyopathy Following Therapeutic Pericardiocentesis. JACC Case Rep 2020; 2:1009-1013. [PMID: 34317403 PMCID: PMC8302087 DOI: 10.1016/j.jaccas.2020.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/03/2020] [Indexed: 11/30/2022]
Abstract
Pericardial decompression syndrome, defined as paradoxical hypotension and pulmonary edema after pericardiocentesis, is a rare complication of pericardiocentesis. Stress cardiomyopathy, caused by excess catecholamine response resulting in left ventricular dysfunction and elevated cardiac enzymes, can overlap with pericardial decompression syndrome, and both might belong to the same spectrum of disease. (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Roberto C. Cerrud-Rodriguez
- Address for correspondence: Dr. Roberto C. Cerrud-Rodriguez, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, New York 10467.
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26
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Ryu AJ, Kane GC, Pislaru SV, Lekhakul A, Geske JB, Luis SA, Michelena HI, Nkomo VT, Thaden JJ, Sinak LJ. Bleeding Complications of Ultrasound-Guided Pericardiocentesis in the Presence of Coagulopathy or Thrombocytopenia. J Am Soc Echocardiogr 2020; 33:399-401. [PMID: 31959530 DOI: 10.1016/j.echo.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Affiliation(s)
| | - Garvan C Kane
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sorin V Pislaru
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Annop Lekhakul
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Faculty of Medicine, Ramathibodhi Hospital, Mahidol University, Bangkok, Thailand
| | - Jeffrey B Geske
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sushil A Luis
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Hector I Michelena
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Vuyisile T Nkomo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jeremy J Thaden
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Lawrence J Sinak
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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27
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Nair R, Perez O, Akbik B, Nukta E. Left Internal Mammary Artery Transection: A Rare Complication of Pericardiocentesis. Cureus 2020; 12:e6677. [PMID: 32104617 PMCID: PMC7026879 DOI: 10.7759/cureus.6677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pericardiocentesis is a procedure performed to aspirate fluid from the pericardial space. It is most often performed as an acute therapeutic procedure in cases of massive pericardial effusion or pericardial tamponade. Our case describes an unusual complication of pericardiocentesis leading to hemorrhagic pericardial effusion and hemodynamic compromise.
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Affiliation(s)
- Raunak Nair
- Internal Medicine, Cleveland Clinic - Fairview Hospital, Cleveland, USA
| | - Oscar Perez
- Internal Medicine, Cleveland Clinic - Fairview Hospital, Cleveland, USA
| | - Bassel Akbik
- Critical Care Medicine, Cleveland Clinic, Cleveland, USA
| | - Emad Nukta
- Cardiovascular Medicine, Cleveland Clinic, Cleveland, USA
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28
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Percutaneous Treatment of Right Ventricular Rupture with ADO II device via the Subxiphoid Pericardial Window; After Percutaneous Treatment of Cardiac Tamponade. Anatol J Cardiol 2020; 25:360-362. [PMID: 33960313 DOI: 10.14744/anatoljcardiol.2020.37863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Kaniecki DM. Pericardiocentesis in an Ambulance: A Case Report and Lessons Learned. Air Med J 2019; 38:382-385. [PMID: 31578979 DOI: 10.1016/j.amj.2019.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/15/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023]
Abstract
There are few procedures performed in the prehospital setting as intimidating as pericardiocentesis. We report a case in which lifesaving pericardiocentesis was performed in the back of an ambulance after temporizing measures of volume resuscitation and vasopressor therapy failed. Fluid accumulation within the pericardial sac can increase pressures around the heart and lead to cardiac tamponade. Helicopter emergency medical service crews may be called to transport patients with cardiac tamponade physiology to definitive care where removal of the pericardial fluid can be achieved. Pericardiocentesis is indicated as an emergency procedure in patients with hemodynamic compromise secondary to cardiac tamponade.1 Because most HEMS crews do not routinely perform pericardiocentesis because of the rare need or crew scope of practice limitations, the general approach to management in the prehospital setting is volume resuscitation, to overcome decreased preload, and vasopressor support. Here, we report a case in which lifesaving pericardiocentesis was performed in a ground ambulance after temporizing measures of volume resuscitation and vasopressor therapy failed.
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Affiliation(s)
- David M Kaniecki
- Metro Life Flight, The MetroHealth System, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH.
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Montrief T, Davis WT, Koyfman A, Long B. Mechanical, inflammatory, and embolic complications of myocardial infarction: An emergency medicine review. Am J Emerg Med 2019; 37:1175-1183. [DOI: 10.1016/j.ajem.2019.04.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 04/03/2019] [Indexed: 12/31/2022] Open
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Accadia M, Di Maio M, Iengo R, Arnese M, Cocchia R, Scotto Di Uccio F, Tuccillo A, Mercogliano G, Tuccillo B. Pericardial thrombus and cardiac tamponade after pericardiocentesis with intact heart walls. Echocardiography 2019; 36:803-805. [PMID: 30726561 DOI: 10.1111/echo.14276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 01/13/2019] [Accepted: 01/15/2019] [Indexed: 11/30/2022] Open
Abstract
A young patient affected by a lung neoplasm, presented at emergency department with cardiac tamponade, underwent pericardiocentesis with a prompt restoration of hemodynamic stability. An hour later, the patient presented again signs of tamponade, without evidence of fluids in the drainage that was left in pericardial space. The echocardiography revealed an intrapericardial thrombus compressing the right chambers. An emergency pericardiotomy was performed and a large thrombus was removed from the pericardial space; cardiac walls were intact. Echocardiography played a pivotal role for the identification of a pericardial thrombus as a complication of pericardiocentesis.
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Affiliation(s)
- Maria Accadia
- Department of Cardiology, Ospedale del Mare, Naples, Italy
| | - Marco Di Maio
- Department of Cardiology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaele Iengo
- Department of Cardiology, Ospedale del Mare, Naples, Italy
| | | | - Renato Cocchia
- Department of Cardiology, Ospedale del Mare, Naples, Italy
| | | | - Andrea Tuccillo
- Department of Cardiology, University of Messina, Messina, Italy
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Peritonitis and pneumoperitoneum after successful emergency pericardiocentesis in the case of a Chilaiditi syndrome. J Geriatr Cardiol 2019; 16:60-62. [PMID: 30800153 PMCID: PMC6379237 DOI: 10.11909/j.issn.1671-5411.2019.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Maggiolini S, De Carlini CC, Imazio M. Evolution of the pericardiocentesis technique. J Cardiovasc Med (Hagerstown) 2018; 19:267-273. [PMID: 29553993 DOI: 10.2459/jcm.0000000000000649] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
: Pericardiocentesis is a valuable technique for the diagnosis and treatment of patients with pericardial effusion and cardiac tamponade, although it may be associated with potentially serious complications. Through the years, many different imaging approaches have been described to reduce the complication rate of the procedure. This systematic review provides a focused overview of the different techniques developed in recent years to reduce the procedural complications and to increase the related success rate.
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Affiliation(s)
- Stefano Maggiolini
- Cardiology Division, Cardiovascular Department, San L. Mandic Hospital, Merate
| | | | - Massimo Imazio
- Cardiology, Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, Torino, Italy
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Fiocca L, Cereda AF, Bernelli C, Canova PA, Serino F, Niglio T, Musumeci G, Guagliumi G, Vassileva A, Senni M, Valsecchi O. Autologous blood reinfusion during iatrogenic acute hemorrhagic cardiac tamponade: Safety and feasibility in a cohort of 30 patients. Catheter Cardiovasc Interv 2018; 93:E56-E62. [DOI: 10.1002/ccd.27784] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 05/29/2018] [Accepted: 06/20/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Luigi Fiocca
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Alberto F. Cereda
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Chiara Bernelli
- Interventional Cardiology Unit, ASST Nord Milano; Ospedale Edoardo Bassini; Cinisello Balsamo (MI) Italy
| | - Paolo A. Canova
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Federica Serino
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Tullio Niglio
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Giuseppe Musumeci
- Cardiovascular Department; Ospedale Santa Croce e Carle; Cuneo Italy
| | - Giulio Guagliumi
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | | | - Michele Senni
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
| | - Orazio Valsecchi
- Cardiovascular Department; Ospedale Papa Giovanni XXIII; Bergamo Italy
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Hargreaves L, Gosling L, Dixon JJ. Pericardial effusion and congestive heart failure in a horse with multicentric lymphoma. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 20-year-old Warmblood mare was evaluated for acute-onset tachycardia and a one-week history of lethargy and ventral oedema. Haematology revealed leucocytosis with neutrophilia. Ultrasonographic examination revealed pericardial effusion and cardiac tamponade consistent with right-sided congestive heart failure. Abdominal ultrasonography demonstrated loss of definition of the right kidney and a structure adjacent to the kidney suggestive of a renal neoplasm. A tentative antemortem diagnosis of multicentric neoplasia, most likely lymphoma, was made. The horse was subjected to euthanasia due to a grave prognosis. Postmortem examination and histological evaluation were consistent with lymphoma, including infiltration of the cardiac muscle with neoplastic cells. Although lymphoma has been reported to affect the heart, congestive heart failure due to cardiac and pericardial neoplastic infiltration has not been previously reported as the presenting complaint. This case report describes the diagnostic approach to pericardial effusion and congestive heart failure in a mare with lymphoma.
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Hijikata S, Miyamoto T, Yamaguchi T, Yamaguchi J, Iwai T, Watanabe K, Sagawa Y, Masuda R, Miyazaki R, Miwa N, Hara N, Nagata Y, Nozato T. Hemorrhagic shock due to branch injury of the left internal thoracic artery two days after pericardiocentesis. J Cardiol Cases 2018; 18:5-8. [DOI: 10.1016/j.jccase.2018.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/03/2018] [Accepted: 02/28/2018] [Indexed: 11/26/2022] Open
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Chalikias G, Samaras A, Ziakas A, Kikas P, Thomaidis A, Drosos I, Giannakoulas G, Karvounis H, Konstantinides S, Tziakas D. Novel echocardiographic prognostic markers for cardiac tamponade in patients with large malignant pericardial effusions: A paradigm shift from flow to tissue imaging. Echocardiography 2017; 34:1315-1323. [PMID: 28685870 DOI: 10.1111/echo.13620] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND With this study, we sought to investigate the prognostic value of echocardiographic tissue imaging markers in predicting tamponade among patients with large malignant pericardial effusion compared to routinely used echocardiographic signs. METHODS A total of 96 consecutive patients with large malignant pericardial effusion, not in clinical cardiac tamponade, underwent an echocardiographic examination and were prospectively assessed for 1 month. Clinically evident cardiac tamponade was considered as the study endpoint. The prognostic performance of tricuspid valve annular plane systolic excursion (TAPSE) and peak systolic annular velocity at the lateral margin of the tricuspid valve annulus (STV ) was assessed and compared to routinely used imaging signs. RESULTS During follow-up, 37 patients (39%) developed clinically evident cardiac tamponade. TAPSE (area under the curve [AUC] 0.958) and STV (AUC 0.948) had excellent predictive accuracy for tamponade. Multivariate analysis showed that TAPSE (Hazard ratio [HR] 3.03; 95% CI 1.60-5.73, P=.001) and STV (HR 1.17; 95% CI 1.05-1.29, P=.005) remained independent significant predictors of cardiac tamponade. Reclassification analysis and decision curve analysis showed additive prognostic value and adjunct clinical benefit of these markers when added to a recently published triage pericardiocentesis score. CONCLUSION Echocardiographic tissue imaging markers such as TAPSE and STV are characterized by an excellent prognostic ability for development of cardiac tamponade and better prognostic value compared to routine echocardiographic signs in patients with large malignant pericardial effusion. Incorporating these markers to a recent triage pericardiocentesis score resulted in additional prognostic value and increased clinical benefit.
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Affiliation(s)
- George Chalikias
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Antonios Samaras
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Antonios Ziakas
- First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros Kikas
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Adina Thomaidis
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Drosos
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - George Giannakoulas
- First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Cardiology Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Konstantinides
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitrios Tziakas
- Cardiology Department, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Oliveira-Santos M, Jorge E, Leite RBL, Martins R, Calisto J, Matos V, Pego M. Acute pneumopericardium: when echocardiography is not enough. ACUTE CARDIAC CARE 2016; 18:85. [PMID: 29452003 DOI: 10.1080/17482941.2017.1363394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Elisabete Jorge
- a Cardiology A, University Hospitals of Coimbra , Coimbra , Portugal
| | | | - Rui Martins
- a Cardiology A, University Hospitals of Coimbra , Coimbra , Portugal
| | - João Calisto
- a Cardiology A, University Hospitals of Coimbra , Coimbra , Portugal
| | - Vítor Matos
- a Cardiology A, University Hospitals of Coimbra , Coimbra , Portugal
| | - Mariano Pego
- a Cardiology A, University Hospitals of Coimbra , Coimbra , Portugal
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Pneumopericardium Following Pericardiocentesis. Am J Med 2016; 129:e181-2. [PMID: 27107923 DOI: 10.1016/j.amjmed.2016.03.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 03/25/2016] [Accepted: 03/25/2016] [Indexed: 11/22/2022]
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Moffatt-Bruce S, Hefner JL, Nguyen MC. What is new in critical illness and injury science? Patient safety amidst chaos: Are we on the same team during emergency and critical care interventions? Int J Crit Illn Inj Sci 2015; 5:135-7. [PMID: 26557481 PMCID: PMC4613410 DOI: 10.4103/2229-5151.164909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Susan Moffatt-Bruce
- The Ohio State University Wexner Medical Center, Department of Surgery, Columbus, Ohio, USA
| | - Jennifer L Hefner
- The Ohio State University Wexner Medical Center, Department of Family Medicine, Columbus, Ohio, USA
| | - Michelle C Nguyen
- The Ohio State University Wexner Medical Center, Department of Surgery, Columbus, Ohio, USA
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