ABSTRACT
La incidencia del síndrome aórtico agudo (disección aórtica, hematoma intramural, úlcera aterosclerótica penetrante y ruptura de la pared vascular) es de 2-3,5 casos por 100.000 habitantes cada año; pero la disección aórtica tipo A retrógrada es poco frecuente y sólo se han reportado casos aislados, en ocasiones como consecuencia de una intervención quirúrgica. Se presenta el caso clínico de un paciente de 62 años de edad, que acudió al cuerpo de guardia por dolor precordial que alivió con analgésicos y tanto la radiografía de tórax como el electrocardiograma eran normales. Al tercer día comenzó con fiebre que duró 4 semanas y desapareció espontáneamente, y fue dado de alta con todos los estudios normales y pancultivos negativos. Dos semanas después ingresa nuevamente por disnea de esfuerzo, que fue progresando. Al ingreso se constata signos clínicos de pericarditis, incluyendo roce pericardio, realizándose ecocardiograma y angio-TAC, donde se evidenció el diagnóstico de disección aórtica tipo B complicada con disección tipo A retrógrada y hemopericardio.
The incidence of acute aortic syndrome (aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer rupture of the vessel wall) is 2-3.5 cases per 100,000 people each year; but the retrograde type A aortic dissection is rare and only isolated cases have been reported, sometimes as a result of surgery. We report a case of a 62-year-old, who came to the emergency for chest pain relieved with analgesics and both chest radiography and electrocardiography were normal. On the third day began with fever that lasted for four weeks and disappeared spontaneously, was discharged with all studies normal and negatives cultives. Two weeks later admitted again by dyspnea on exertion, this was progressing. On admission to hospital clinical signs of pericarditis it is found, including pericardium rubbing, performing echocardiography and CT angiography, where the diagnosis of type B aortic dissection complicated with retrograde type A aortic dissection and hemopericardium was demonstrated.
A incidência de síndrome aórtica aguda (dissecção aórtica, hematoma intramural e penetrante ruptura úlcera aterosclerótica da parede do vaso) é 2-3,5 casos por 100.000 pessoas a cada ano; mas a dissecção aórtica tipo A retrógrada é rara e apenas casos isolados foram relatadas, algumas vezes como resultado da cirurgia. Nós relatamos o caso de um paciente de 62 anos de idade, que veio para a emergência por dor torácica aliviado com analgésicos e tanto a radiografia de tórax e eletrocardiograma eram normais. Ao terceiro dia o paciente começou com febre a qual durou quatro semanas e desapareceu espontaneamente, recebendo alta com todos os estudos normais e pancultivos negativos. Duas semanas mais tarde, ele foi internado no hospital novamente para a dispnéia, que estava progredindo. Na admissão do hospital sinais clínicos de pericardite foram encontrado, incluindo fricção pericárdica, realizando ecocardiografia e angiografia por TC, que revelou o diagnóstico de dissecção aórtica tipo B complicada com dissecção aórtica tipo A retrógrada e hemopericárdio.
ABSTRACT
Acupuncture-related hemopericardium is a rare but potentially fatal complication. We describe a hemopericardium that occurred shortly after acupuncture in a 55-year-old woman. A chest CT scan and echocardiography revealed a hemopericardium, and pericardiocentesis was then immediately and successfully performed. Subsequently, her clinical course improved. This case increases the attention of emergency physicians for acupuncture-related complications, especially hemopericardium, and the necessity of rapid diagnosis and management.
Subject(s)
Female , Humans , Middle Aged , Acupuncture Therapy/adverse effects , Echocardiography , Pericardial Effusion/diagnosis , PericardiocentesisABSTRACT
Acupuncture-related hemopericardium is a rare but potentially fatal complication. We describe a hemopericardium that occurred shortly after acupuncture in a 55-year-old woman. A chest CT scan and echocardiography revealed a hemopericardium, and pericardiocentesis was then immediately and successfully performed. Subsequently, her clinical course improved. This case increases the attention of emergency physicians for acupuncture-related complications, especially hemopericardium, and the necessity of rapid diagnosis and management.
Subject(s)
Female , Humans , Middle Aged , Acupuncture Therapy/adverse effects , Echocardiography , Pericardial Effusion/diagnosis , PericardiocentesisABSTRACT
Primary cardiac angiosarcoma is a very rare disease with a poor prognosis. We report a case of a patient with a primary cardiac angiosarcoma who presented with cardiac tamponade; the angiosarcoma was successfully resected surgically.
Subject(s)
Humans , Cardiac Tamponade , Heart Neoplasms , Hemangiosarcoma , Pericardial Effusion , Prognosis , Rare DiseasesABSTRACT
The heart may be critically damaged by objects of unimpressive size or appearance. We report a case of cardiac tamponade due to penetration of the right ventricle by an acupunture needle. A 59-year-old man was admitted due to dyspnea and chest pain. He had recieved acupuncture therapy during 10 years for chronic right upper abdominal pain. He was diagnosed as cardiac tamponade due to hemopericardium caused by an broken a cupuncture needle detected on fluoroscopy, computerized tomography and trans-esophageal echocardiography, and the needle was successfully removed by cardiac surgery. The patient was discharged uneventfully and followed at the outpatient department.