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1.
Rev. bras. cir. cardiovasc ; 35(6): 1017-1019, Nov.-Dec. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1144003

ABSTRACT

Abstract Case Presentation: A case of a 49-year-old patient, male, victim of stab wound, developing belatedly cardiac tamponade and hemodynamic stability was reported. The patient underwent a pericardial window with drainage of pericardial effusion of blackened aspect; however, without visualization of the cardiac lesion, enlargement of the incision by median sternotomy was opted for. A hematoma was spotted at the left ventricle with epicardial lesion and a patch of pericardium was made with 3-0 polypropylene. The patient developed acute pulmonary edema and atrial fibrillation, which improved after the intensive care unit clinical management, with hospital discharge in the 7th postoperative day.


Subject(s)
Humans , Male , Middle Aged , Pericardial Effusion/surgery , Pericardial Effusion/etiology , Pericardial Effusion/diagnostic imaging , Cardiac Tamponade/surgery , Cardiac Tamponade/etiology , Cardiac Tamponade/diagnostic imaging , Wounds, Penetrating , Wounds, Stab/surgery , Wounds, Stab/complications , Sternotomy
2.
Rev. bras. cir. cardiovasc ; 35(4): 577-579, July-Aug. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1137308

ABSTRACT

Abstract Early recognition and rapid and appropriate treatment of cardiac tamponade are mandatory to prevent the irreversible deterioration of cerebral perfusion and other important organs. In this study, cardiac tamponade was induced by inadvertent transseptal puncture, which was managed with pericardial drainage and surgical repair in a patient with symptomatic paroxysmal atrial fibrillation. Epicardial atrial fibrillation ablation and left atrial appendage amputation were also performed at the same time.


Subject(s)
Humans , Atrial Fibrillation/surgery , Atrial Fibrillation/etiology , Cardiac Tamponade/etiology , Cardiac Tamponade/diagnostic imaging , Atrial Appendage/surgery , Atrial Appendage/diagnostic imaging , Cardiac Tamponade/surgery , Treatment Outcome , Catheter Ablation , Catheters , Amputation
3.
Rev. bras. anestesiol ; 68(6): 633-636, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-977400

ABSTRACT

Abstract Background and objectives: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. Case report: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit. However, after 5 min in the Post-Anesthesia Care Unit, he suddenly became hypotensive and dyspneic. He responded poorly to inotropics and fluid resuscitation. Transesophageal echocardiography conducted by an anesthesiologist who suspected a cardiac etiology revealed a pericardial effusion compressing the heart. After a failed attempt of pericardiocentesis, an emergency pericardial window operation was performed. The patient improved dramatically once the heart was decompressed. Conclusion: Since cardiac tamponade is generally not suspected as a cause of hemodynamic instability after a lung lobectomy, as it was in this case, a misdiagnosis of the patient's condition may have led to improper management resulting in death. As anesthesiologists are often involved in the initial resuscitation of morbid patients in Post-Anesthesia Care Units, their acquaintance with various postoperative complications and competence in echocardiography for assessing cardiac problems may contribute to patient survival.


Resumo Justificativa e objetivos: O tamponamento cardíaco é uma condição médica potencialmente fatal, cuja ocorrência como uma complicação da lobectomia pulmonar é muito rara. Apresentamos o primeiro caso de tamponamento cardíaco desencadeado na sala de recuperação pós-anestésica (SRPA) após uma lobectomia pulmonar. Relato de caso: Paciente do sexo masculino, 54 anos, com carcinoma de células escamosas pulmonares, submetido à lobectomia pulmonar aparentemente sem complicações. Sua hemodinâmica não apresentou alteração durante toda a cirurgia e também inicialmente na sala de recuperação pós-anestésica. Porém, após cinco minutos na SRPA, o paciente apresentou hipotensão e dispneia de forma repentina e respondeu mal ao inotrópico e à reanimação hídrica. Uma ecocardiografia transesofágica feita por um anestesiologista que suspeitou de etiologia cardíaca revelou um derrame pericárdico que comprimia o coração. Após tentativa malsucedida de pericardiocentese, foi feita uma janela pericárdica de emergência. O paciente apresentou melhoria dramática com a descompressão do coração. Conclusão: Como o tamponamento cardíaco geralmente não é suspeito como causa de instabilidade hemodinâmica após lobectomia pulmonar, como ocorreu neste caso, um diagnóstico errado da condição do paciente poderia ter levado a um manejo inadequado, que resultaria em morte. Como os anestesiologistas estão frequentemente envolvidos na reanimação inicial de pacientes debilitados em salas de recuperação pós-anestésica, seu conhecimento de várias complicações pós-operatórias e competência na ecocardiografia para avaliar problemas cardíacos podem contribuir para a sobrevivência do paciente.


Subject(s)
Humans , Male , Pneumonectomy/adverse effects , Postoperative Complications/etiology , Cardiac Tamponade/etiology , Anesthesia Recovery Period , Fatal Outcome , Hospital Units , Middle Aged
6.
Rev. bras. cir. cardiovasc ; 33(1): 99-103, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-897974

ABSTRACT

Abstract Penetrating cardiac trauma has been increasing in clinical experience and is joined to important morbidity and mortality. A case of a 38-year-old female with history of postpartum depression was reported, admitted to our department for cardiac tamponade due to penetrating self-inflicted multiple stab wound of the chest complicated by rupture of anterior left ventricular wall and traumatic ventricular septal defect. Following the unstable hemodynamic instability, a combined therapeutic strategy was chosen: surgery and transcatheter implantation to correct free wall ventricle damage and traumatic ventricular septal defect, respectively.


Subject(s)
Humans , Male , Adult , Wounds, Penetrating/complications , Cardiac Tamponade/etiology , Heart Injuries/etiology , Patient Care Team , Wounds, Penetrating/surgery , Echocardiography , Cardiac Tamponade/surgery , Self-Injurious Behavior/complications , Coronary Angiography , Heart Injuries/surgery
7.
Rev. bras. anestesiol ; 68(1): 104-108, Jan.-Feb. 2018. graf
Article in English | LILACS | ID: biblio-897806

ABSTRACT

Abstract The extensive use of central venous catheters (CVC) in a hospital environment leads to increased iatrogenic complications, as more catheters are used enclosed and its maintenance is prolonged. Several complications are known to be related to central venous catheter, of which the uncommon cardiac tamponade (CT), hardly recognized and associated with high mortality. We present a clinical case, with favorable outcome, of a patient who developed a CT 17 days after CVC placement, and try to reflect on the measures that can be taken to reduce its incidence, as well as the therapeutic approaches to practice in the presence of a suspected CT.


Resumo O vasto uso dos cateteres venosos centrais (CVC) em meio hospitalar incita a um aumento da iatrogenia, uma vez que são colocados mais cateteres e a sua manutenção é mais prolongada. São conhecidas as complicações relacionadas com a cateterização venosa central, uma das quais o tamponamento cardíaco (TC), raro, dificilmente reconhecido e associado a grande mortalidade. Os autores apresentam um caso clínico, com desfecho favorável, de uma doente que desenvolveu um TC 17 dias após a colocação de um CVC e procuram refletir sobre as medidas que podem ser adotadas para reduzir a sua incidência, bem como as atitudes terapêuticas na suspeita de TC.


Subject(s)
Humans , Female , Adult , Cardiac Tamponade/etiology , Central Venous Catheters/adverse effects
8.
Rev. inf. cient ; 97(1): i:138-f:145, 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-995964

ABSTRACT

Se realizó un estudio descriptivo, retrospectivo y longitudinal con el objetivo de caracterizar aspectos de interés en 13 pacientes con taponamiento cardíaco egresados de la unidad de cuidados intensivos del Hospital "Dr. Agostinho Neto" de Guantánamo durante el período 2010­2016. Este padecimiento puede ser la forma de presentación de metástasis pericárdica de diferentes neoplasias Se estudiaron las siguientes variables: edad, sexo, estado al egreso, estudios complementarios realizados, diagnósticos y tratamiento aplicado. La edad de los pacientes fue de 66.5 ± 10.1 años; predominó el sexo masculino y todos egresaron fallecidos. Se realizaron estudios de hemoquímica, ecocardiograma transtorácico, pericardiocentésis, estudio de líquido pericárdico (citoquímico, citológico y bacteriológico) y radiografía de tórax. Las causas más comunes fueron la neoplasia del pulmón y de mama. El taponamiento cardiaco se expresa como una forma de presentación de derrames pericárdicos malignos, por lo que se debe tener en cuenta esta apreciación ante un paciente críticamente enfermo por derrame pericárdico de gran cuantía(AU)


Introduction: Cardiac tamponade may be the form of presentation of pericardial metastases of different neoplasms. Objective: to characterize aspects of interest in patients with cardiac tamponade from the intensive care unit of the Hospital "Dr. Agostinho Neto de Guantánamo during the period 2010-2016. Material and method: A descriptive, retrospective and longitudinal study was carried out. The following variables were studied: age, sex, state at discharge, complementary studies performed, semiodiagnostics and applied treatment. Results: the age of the patients was 66.5 ± 10.1 years; The majority were men (61.5%) and died (61.5%). All patients underwent haemochemistry, transthoracic echocardiography, pericardiocentesis, pericardial fluid (cytochemical, cytological and bacteriological) and chest X-rays. The most common causes were lung neoplasia (30.7%) and breast cancer (23.1%). Conclusions: cardiac tamponade is expressed as a form of presentation of malignant pericardial effusions, and this should be taken into account in a critically ill patient due to large pericardial effusion(AU)


Subject(s)
Humans , Middle Aged , Pericardial Effusion/complications , Cardiac Tamponade/etiology , Epidemiology, Descriptive , Retrospective Studies , Longitudinal Studies
9.
Rev. Col. Bras. Cir ; 45(4): e1888, 2018. tab
Article in Portuguese | LILACS | ID: biblio-956567

ABSTRACT

RESUMO Objetivo: determinar o índice de trauma cardíaco fatal na cidade de Manaus e esclarecer os mecanismos de trauma e de morte, o tratamento hospitalar prévio, assim como as lesões associadas ao trauma cardíaco. Métodos: estudo retrospectivo, observacional, transversal, que revisou os laudos de necropsias do Instituto Médico Legal de Manaus entre novembro de 2015 e outubro de 2016, cuja causa mortis foi lesão cardíaca. Resultados: o índice de trauma cardíaco foi de 5,98% (138 casos) dentre 2306 necropsias realizadas no período do estudo. Homens foram afetados em 92%. A mediana de idade foi de 27 anos (14 a 83). A arma de fogo foi o mecanismo de trauma em 62,3% e a arma branca em 29,7%. A exsanguinação foi responsável pela maioria das mortes e o tamponamento cardíaco esteve presente em segundo lugar. Óbito no local ocorreu em 86,2%. Os ventrículos foram as câmaras mais lesionadas. O hemotórax foi descrito em 90,6%. Apenas 23 (16,7%) doentes foram removidos até o pronto socorro, porém seis deles (26,2%) não foram submetidos à toracotomia, apenas à drenagem de tórax. O pulmão foi acometido em 57% unilateralmente e 43% bilateralmente. Conclusão: o trauma cardíaco fatal representou um índice de 5,98% na cidade de Manaus. A maioria dos doentes morre na cena do trauma, geralmente devido à exsanguinação causada por ferimento de arma de fogo. Cerca de um quarto dos pacientes que chegaram ao pronto socorro e morreram, não foram diagnosticados com trauma cardíaco em tempo hábil.


ABSTRACT Objective: to determine the frequency of fatal cardiac trauma in the city of Manaus, Brazil, between November 2015 and October 2016, and to clarify the mechanisms of trauma and death, previous hospital treatment, as well as the injuries associated with cardiac trauma. Methods: retrospective, observational, and cross-sectional study, which reviewed the necropsy reports of individuals whose cause of death was cardiac injury. Results: the cardiac trauma rate was of 5.98% (138 cases) out of 2,306 necropsies performed in the study period by Instituto Médico Legal (IML) de Manaus (IML is a Brazilian institute responsible for necropsies and cadaveric reports). Males accounted for 92% of the cases. The median age was 27 years (14-83). Gunshot wounds (GSW) was the trauma mechanism in 62.3% and stab wound (SW) in 29.7%. Exsanguination was responsible for most of the deaths and cardiac tamponade was present in second place. On-site death occurred in 86.2% of the cases. The ventricles were the most common site of cardiac injury. Hemothorax was identified in 90.6% of the individuals. Only 23 patients (16.7%) were taken to the hospital (Emergency Room), but six (26.2%) were submitted only to chest drainage, not to thoracotomy. The lung was unilaterally affected in 57% of the cases and bilaterally in 43%. Conclusion: fatal cardiac trauma represented an index of 5.98% in the city of Manaus. Most patients die at the scene of the trauma, usually due to exsanguination caused by gunshot wound. About a quarter of patients who reached the hospital and died were not diagnosed with cardiac trauma in time.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Thoracic Injuries/mortality , Cardiac Tamponade/mortality , Exsanguination/mortality , Heart Injuries/mortality , Thoracic Injuries/classification , Thoracic Injuries/etiology , Wounds, Gunshot/mortality , Wounds, Stab/mortality , Brazil/epidemiology , Cardiac Tamponade/etiology , Trauma Severity Indices , Cross-Sectional Studies , Retrospective Studies , Exsanguination/etiology , Heart Injuries/classification , Heart Injuries/etiology , Middle Aged
10.
Rev. Col. Bras. Cir ; 45(3): e1818, 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-956563

ABSTRACT

RESUMO Objetivo: determinar a incidência de derrame pericárdico com tamponamento cardíaco em recém-natos prematuros em uma unidade de terapia intensiva pediátrica, com ênfase na relação entre o derrame pericárdico e a inserção de cateter central de inserção periférica, e avaliar o papel da ultrassonografia à beira do leito na abordagem desses casos. Métodos: análise retrospectiva dos pacientes internados em unidade de terapia intensiva pediátrica, entre julho de 2014 e dezembro de 2016, que apresentaram derrame pericárdico com repercussão hemodinâmica, avaliados por ultrassonografia. Resultados: foram estudados 426 pacientes admitidos na unidade neonatal de cinco leitos, com realização 285 ultrassonografias à beira do leito. Foram encontrados seis casos de derrame pericárdico, sendo quatro casos com choque obstrutivo e necessidade de realização de drenagem pericárdica, sem mortalidade relacionada ao procedimento e com melhora hemodinâmica em todos os pacientes após o procedimento. A incidência de derrame pericárdico foi de 2,4 casos por ano. Conclusão: a incidência de derrame pericárdico é baixa em neonatos, porém o diagnóstico precoce é fundamental devido à alta morbimortalidade, especialmente nos casos de instalação abrupta. Todos os casos foram diagnosticados pela ultrassonografia à beira do leito, demonstrando sua importância no rastreio desses casos, especialmente em nos quadros de choque de etiologia incerta e neonatos com instabilidade hemodinâmica de início súbito que estão em uso de acesso venoso central.


ABSTRACT Objective: to determine the incidence of pericardial effusion with cardiac tamponade in preterm infants in a pediatric intensive care unit, with emphasis on the relationship between pericardial effusion and peripherally inserted central catheter, and to evaluate the role of bedside ultrasound in approaching these cases. Methods: we conducted a retrospective analysis of patients admitted to a pediatric intensive care unit between July 2014 and December 2016, who presented pericardial effusion with hemodynamic repercussion, evaluated by ultrasonography. Results: we studied 426 patients admitted to the five beds of the neonatal unit. In the period, there were 285 bedside ultrasound exams. We found six cases of pericardial effusion, four of which with obstructive shock and need for pericardial drainage. There was no procedure-related mortality, and all patients evolved with hemodynamic improvement after the procedure. The incidence of pericardial effusion was 2.4 cases per year. Conclusion: the incidence of pericardial effusion is low in neonates, but early diagnosis is fundamental due to high morbidity and mortality, especially in cases of abrupt onset. All cases were diagnosed by bedside ultrasonography, demonstrating its importance in the screening of these cases, especially in shocks of uncertain etiology and neonates with sudden onset hemodynamic instability who are using central venous access.


Subject(s)
Humans , Male , Female , Infant, Newborn , Pericardial Effusion/etiology , Pericardial Effusion/diagnostic imaging , Infant, Premature , Catheterization, Peripheral/adverse effects , Echocardiography/methods , Cardiac Tamponade/etiology , Cardiac Tamponade/diagnostic imaging , Pericardial Effusion/therapy , Pericardial Effusion/epidemiology , Brazil/epidemiology , Cardiac Tamponade/therapy , Cardiac Tamponade/epidemiology , Intensive Care Units, Neonatal , Incidence , Retrospective Studies , Treatment Outcome , Point-of-Care Systems , Hemodynamics
12.
Rev. méd. Chile ; 144(3): 394-400, mar. 2016. ilus, tab
Article in Spanish | LILACS | ID: lil-784911

ABSTRACT

Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytic disorder. We report a 76-years-old man who suffered a cardiac tamponade secondary to ECD. A pericardial window was made and during the operation the surgeons observed that the myocardium was diffusely infiltrated. Twenty-eight months before, ECD was clinically diagnosed and prednisone and methotrexate were prescribed. Due to disease progression which culminated in the cardiac tamponade, methotrexate was changed to sirolimus aiming to obtain plasma levels between 5-8 ng/ml. This treatment stabilized his cardiac function allowing a survival of 52 months after its initiation, with fewer side effects.


Subject(s)
Humans , Male , Aged , Prednisone/therapeutic use , Cardiac Tamponade/etiology , Sirolimus/therapeutic use , Erdheim-Chester Disease/complications , Erdheim-Chester Disease/drug therapy , Anti-Inflammatory Agents/therapeutic use , Cardiac Tamponade/diagnostic imaging , Methotrexate/therapeutic use , Treatment Outcome , Disease-Free Survival , Immunosuppressive Agents/therapeutic use
13.
Article in English | WPRIM | ID: wpr-85710

ABSTRACT

Pneumopericardium is defined as the presence of air inside the pericardial space. Usually, it is reported as a complication of blunt or penetrating chest trauma, but rare iatrogenic and spontaneous cases have been reported. Pneumopericardium is relatively stable if it does not generate a tension effect on the heart. However, it may progress to tension pneumopericardium, which requires immediate pericardial aspiration. We report a case of iatrogenic pneumopericardium occurred in a 70-year-old man who presented dyspnea at emergency department. The patient underwent pericardiocentesis for cardiac tamponade due to large pericardial effusion, and iatrogenic tension pneumopericardium occurred due to misuse of the drainage device. After evacuating the pericardial air through the previously implanted catheter, the patient became stable. We report this case to increase the awareness of this fatal condition and to help increase the use of precautions against the development of this condition during emergency procedures.


Subject(s)
Aged , Cardiac Tamponade/etiology , Drainage , Dyspnea/diagnosis , Emergency Medical Services , Heart Ventricles/physiopathology , Humans , Male , Medical Errors , Pericardial Effusion/diagnostic imaging , Pericardiocentesis , Pneumopericardium/diagnosis , Tomography, X-Ray Computed
14.
Ann Card Anaesth ; 2015 Jul; 18(3): 445-448
Article in English | IMSEAR | ID: sea-162400

ABSTRACT

Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43‑year‑old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.


Subject(s)
Adult , Cardiac Tamponade/etiology , Cardiac Tamponade/mortality , Cardiac Tamponade/surgery , Death, Sudden/etiology , Echinococcosis/complications , Echinococcosis/diagnosis , Echinococcosis/mortality , Heart Ventricles/pathology , Humans , Male , Pericardium/injuries , Pericardium/surgery , Rupture
16.
Arch. cardiol. Méx ; 84(2): 86-91, abr.-jun. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-732011

ABSTRACT

Objetivo: Conocer la prevalencia, las causas, los hallazgos clínicos, ecocardiográficos, microbiológicos y citopatológicos de pacientes con derrame pericárdico. Métodos: Estudio observacional, retrospectivo, transversal y analítico. Se analizaron expedientes clínicos de pacientes que reciben pericardiocentesis durante un periodo de 5 años. Se empleó estadística descriptiva, con medidas de tendencia central y de dispersión para el análisis. Resultados: La prevalencia de derrame pericárdico fue del 1.1%. Predominó en mujeres (60.4%) y se observó una media de edad de 49 años. La principal causa asociada fue neoplásica, con un 32.1%, seguida de la idiopática y reumatológica con un 27.4 y 10.4%, respectivamente. Se presentó taponamiento cardiaco en un 27.1%, siendo la disnea y la presencia de tonos cardiacos apagados los datos clínicos más comunes. El colapso auricular y ventricular derechos se presentaron en el 84.9 y 75.5%, respectivamente. El estudio citopatológico de líquido pericárdico presentó un mayor rendimiento diagnóstico en el estudio de derrames asociados a neoplasias, mostrando una sensibilidad del 54%, una especificidad del 95%, un valor predictivo positivo del 85% y un valor predictivo negativo del 81%. Conclusiones: La prevalencia de derrame pericárdico en un hospital de tercer nivel fue del 1.1%, predominando la etiología neoplásica. El colapso auricular y ventricular derechos son los hallazgos ecocardiográficos más comunes en la presencia de derrame pericárdico moderado o severo. El estudio citopatológico tiene una alta especificidad ante la sospecha de causa neoplásica.


Objective: To determine the prevalence, etiology, clinical, echocardiographic, microbiological and cytopathological characteristics of patients with pericardial effusion. Methods: Observational, retrospective, cross-sectional analytical study. We reviewed medical records of patients undergoing pericardiocentesis for a 5 years period. We used descriptive statistics, measures of central tendency and dispersion for analysis. Results: The prevalence of pericardial effusion was 1.1%. Predominant in women (60.4%) and there was a mean age of 49 years. The main causes were neoplastic 32.1%, idiopathic 27.4% and rheumatological 10.4%. A percentage of 27.1 had cardiac tamponade whereas dyspnea and muffled heart sounds were the most common clinical data. The right atrial and ventricular collapse occurred in 84.9 and 75.5%, respectively. The pericardial fluid cytology yielded better in neoplastic causes a sensitivity of 54%, specificity 95%, positive predictive value 85% and negative predictive value 81%. Conclusions: The prevalence of pericardial effusion in a tertiary care hospital was 1.1%, the main cause was neoplastic. In the evaluation of moderate or severe pericardial effusion we found that right atrial and ventricular collapses were the most common echocardiographic findings. The cytopathological study had a high specificity for the diagnosis of neoplasia.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Pericardial Effusion/epidemiology , Pericardial Effusion/etiology , Age Distribution , Cross-Sectional Studies , Cardiac Tamponade/etiology , Echocardiography , Neoplasms/complications , Prevalence , Pericardial Effusion/pathology , Pericardial Effusion/therapy , Pericardiocentesis , Retrospective Studies , Rheumatic Diseases/complications , Sensitivity and Specificity , Sex Distribution , Tertiary Care Centers
17.
Rev. bras. cir. cardiovasc ; 29(2): 285-288, Apr-Jun/2014. tab, graf
Article in English | LILACS | ID: lil-719421

ABSTRACT

Insertion of inferior vena cava filters has been well established in literature, reducing occurrence of pulmonary embolism after an episode of deep venous thrombosis in patients with contraindication to anticoagulation. There are a small number of complications related to procedure and embolization is rare. In this context, we described a case of intracardiac embolization associated with cardiac tamponade.


A colocação percutânea de filtro de veia cava inferior é bem estabelecida em literatura, reduzindo a chance de ocorrência de tromboembolismo pulmonar após um episódio de trombose venosa profunda em pacientes com contraindicações à anticoagulação. O índice de complicações relacionadas ao procedimento é pequeno, sendo embolização evento extremamente raro. Nesse contexto, descrevemos um caso de embolização intracardíaca de filtro de veia cava inferior associada ao tamponamento cardíaco.


Subject(s)
Humans , Male , Middle Aged , Cardiac Tamponade/etiology , Heart Injuries/etiology , Pulmonary Embolism/etiology , Vena Cava, Inferior , Vena Cava Filters/adverse effects , Coronary Angiography , Heart Atria/injuries , Postoperative Complications , Tomography, X-Ray Computed , Venous Thrombosis/etiology
18.
Ann Card Anaesth ; 2014 Jan; 17(1): 67-69
Article in English | IMSEAR | ID: sea-149698

ABSTRACT

A 48-year-old female patient underwent coronary artery bypass surgery. One‑hour after surgery, the patient developed hemodynamic instability. Transthoracic echocardiography (TTE) was inconclusive. Transesophageal echocardiography (TEE) was performed and it revealed localised collection around right atrium. In spite of the evidence of localized tamponade, wait and watch policy was employed rather than re‑exploring the patient emergently. The patient recovered uneventfully. If hemodynamics remain stable and there is no fall in hematocrit and no increase in effusion on TEE/TTE examination, then localized tamponade can be managed conservatively without reexploring the patient.


Subject(s)
Cardiac Tamponade/etiology , Cardiac Tamponade/therapy , Cardiac Tamponade/diagnostic imaging , Coronary Artery Bypass , Coronary Artery Disease/surgery , Coronary Artery Disease/diagnostic imaging , Echocardiography/methods , Echocardiography, Transesophageal , Female , Humans , Middle Aged , Postoperative Complications/therapy , Postoperative Complications/diagnostic imaging , Recovery of Function , Watchful Waiting
20.
Article in English | WPRIM | ID: wpr-44054

ABSTRACT

Endomyocardial biopsy (EMB) is one of the reliable methods for the diagnosis of various cardiac diseases. However, EMB can cause various complications. The purpose of this study is to evaluate the complication of transfemoral EMB with both fluoroscopic and two-dimensional (2-D) echocardiographic guidance. A total of 228 patients (148 men; 46.0+/-14.6 yr-old) who underwent EMB at Kyungpook National University Hospital from January 2002 to June 2012 were included. EMB was performed via the right femoral approach with the guidance of both echocardiography and fluoroscopy. Overall, EMB-related complications occurred in 21 patients (9.2%) including one case (0.4%) with cardiac tamponade requiring emergent pericardiocentesis, four cases (1.8%) with small pericardial effusion without pericardiocentesis, two cases (0.9%) with hemodynamically unstable ventricular tachycardia (VT), one case (0.4%) with nonsustained VT, one case (0.4%) with tricuspid regurgitation, twelve cases (5.3%) with right bundle branch block. There was no occurrence of either EMB-related death or cardiac surgery. Left ventricular ejection fraction was significantly lower (32.0+/-18.7% vs 42.0+/-19.1%, P=0.023) and left ventricular end-diastolic dimension was larger (60.0+/-10.0 mm vs 54.2+/-10.2 mm, P=0.013) in patients with EMB related complications than in those without. It is concluded that transfemoral EMB with fluoroscopic and 2-D echocardiographic guidance is a safe procedure with low complication rate.


Subject(s)
Adult , Biopsy/adverse effects , Cardiac Tamponade/etiology , Echocardiography/adverse effects , Endocardium/diagnostic imaging , Female , Fluoroscopy/adverse effects , Heart Diseases/pathology , Heart Ventricles/metabolism , Humans , Male , Middle Aged , Pericardial Effusion/etiology , Tachycardia, Ventricular/etiology , Ventricular Function
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