1/150. cardiac tamponade and death from intrapericardial rupture [corrected] of sinus of valsalva aneurysm.A 35-year-old woman presented with dyspnea and chest pain. She had a large aneurysm of the non-coronary sinus of valsalva. Before her scheduled urgent surgery, the patient collapsed and died of cardiac tamponade secondary to intrapericardial rupture of the aneurysm. We would advocate urgent repair of this type of lesion to prevent such an outcome. We are aware of no other specific reports addressing extracardiac rupture of non-coronary cusp aneurysms [corrected].- - - - - - - - - - ranking = 1keywords = chest pain, chest, pain (Clic here for more details about this article) |
2/150. hypothyroidism presenting as acute cardiac tamponade with viral pericarditis.This report describes the case of a young woman who presented to an emergency department with severe abdominal pain and shock. The patient was found to have pericardial tamponade due to a massive pericardial effusion. On further evaluation, the etiology of this effusion was considered to be secondary to hypothyroidism with concominant acute viral pericarditis leading to a fulminant tamponade. The presentation, differential diagnosis, and management of pericardial effusion and tamponade secondary to hypothyroidism and viral pericarditis are discussed. The diagnosis of hypothyroidism in conjunction with acute viral pericarditis should be considered in patients presenting with unexplained pericardial effusion and tamponade.- - - - - - - - - - ranking = 0.0033500732320331keywords = pain (Clic here for more details about this article) |
3/150. Post-infarction cardiac rupture.Three allied conditions are described in this paper: (i) haemopericardium with cardiac rupture (5 cases); (ii) haemopericardium without rupture (2 cases); (iii) pseudoaneurysm (1 case). In the first 2 of these, the significant features were clinical deterioration with shock 3 or more days after infarction, recurrent cardiac pain, cardiac tamponade, and immediate or later ineffectiveness of counterpulsation. An additional feature in the second group was the development of haemopericardium after heparin therapy. In the third group, infarction followed by left ventricular failure and progressive cardiac enlargement was the significant feature. An apical systolic murmur was not present, as a false sac had not been formed. Ante-mortem diagnosis depends upon an appreciation of these features. Without it successful surgery is impossible. There were 4 survivors in this group of 8 patients.- - - - - - - - - - ranking = 0.0033500732320331keywords = pain (Clic here for more details about this article) |
4/150. Takayasu's arteritis accompanied with massive pericardial effusion--a case report.A 40-year-old woman who had been treated for Takayasu's arteritis was admitted to the hospital with fever, fatigue, malaise, and severe chest pain. Computed tomography of the chest demonstrated massive pericardial effusion and bilateral pleural effusion. In laboratory data, the c-reactive protein was high at 22.0 mg/dL, and erythrocyte sedimentation rate was also high at 80 mm/hr. The diagnosis was pericarditis with a recurrence of the systemic inflammatory process of Takayasu's arteritis. The patient was treated with methylprednisolone pulse therapy. Her massive pericardial effusion disappeared without pericardiocentesis.- - - - - - - - - - ranking = 1.2468173592228keywords = chest pain, chest, pain (Clic here for more details about this article) |
5/150. An unusual procedure for the treatment of simultaneous pericardial and pleural effusions.BACKGROUND: Symptomatic posterior pericardial effusion (PE) represents a diagnostic challenge since it is not easy to quantify by echocardiography. In addition, this type of effusion is normally treated by surgery because of the difficulty in drainage. CASE: A 59-year-old male presented a symptomatic circumferential PE following mitral valve substitution. Two days after a successful percutaneous subcostal pericardiocentesis, he reported severe dyspnea with hypotension and pulsus paradoxus. At chest x-rays, he showed a left pleural effusion; echocardiography, also performed from the left posterior axillary line, showed a large posterior PE and a large pleural effusion separated by a membrane. A needle was inserted at the fourth intercostal space 2 cm medially to the left posterior axillary line and advanced into the pleural and then into the pericardial cavity under echocardiographic guidance. Serous-hemorrhagic fluid was drained from the pericardial (800 cc) cavity and, after retraction, from the left pleural cavities (600 cc), with consequent hemodynamic improvement. CONCLUSION: Pleuro-pericardiocentesis may represent a valid alternative to surgery for the treatment of cardiac tamponade due to posterior pericardial effusions, in the peculiar situation characterized by the simultaneous presence of a left pleural effusion. This procedure should be performed by qualified physicians under echographic guidance.- - - - - - - - - - ranking = 0.24681735922283keywords = chest (Clic here for more details about this article) |
6/150. Loculated pericardial effusion due to congestive heart failure: an unusual case of vanishing tumor--a case report.Loculation of a pleural effusion within an interlobar fissure as a result of congestive heart failure is a well-known entity. It has been termed "vanishing" or "phantom" tumor because its roentgenographic appearance simulates a pulmonary tumor and resolves with treatment of the congestive heart failure. The authors describe an 89-year-old man with a loculated pericardial effusion on the left cardiac border on chest roentgenogram. This was initially thought to represent an occult metastatic malignancy; however, its etiology became obvious when it disappeared with therapy of heart failure. Loculated pericardial effusion should be included in the differential diagnosis of roentgenographic densities in the chest when seen on the left cardiac border.- - - - - - - - - - ranking = 0.49363471844566keywords = chest (Clic here for more details about this article) |
7/150. Constrictive pericarditis following hemopericardium due to ascending aortic dissection: A case report.A 79-year-old woman, who had had no history of trauma, tuberculosis, or collagen diseases, was referred for examination of general fatigue and shortness of breath on exertion. physical examination revealed engorged neck veins, hepatomegaly, and ascites with abdominal distention. On chest x-ray the cardiac shadow was slightly enlarged and bilateral pleural effusion was present. An electrocardiogram showed low voltage of the QRS complex. Computed tomographic scans revealed two lumens in the remarkably dilated ascending aorta and the severely thickened pericardium. cardiac catheterization showed elevated right atrial pressure and elevated right and left ventricular end-diastolic pressures, in addition to a pressure record of early diastolic dip and end-systolic plateau in the right ventricle. aortography demonstrated aortic dissection localized to the ascending aorta. On the basis of these findings, the diagnosis of chronic ascending aortic dissection complicated with constrictive pericarditis was made. After subtotal pericardiectomy, graft replacement of the ascending aorta and proximal aortic arch was performed with successful results. Her postoperative recovery was uneventful. Histological studies of the pericardium showed fibrosis and marked infiltration of the inflammatory cells. No findings of specific pericarditis such as tuberculosis or collagen diseases were detected.- - - - - - - - - - ranking = 0.24681735922283keywords = chest (Clic here for more details about this article) |
8/150. An unusual cause of unilateral facial pain.Cardiac pain that is referred to the face is a common symptom in patients with angina pectoris, but unilateral facial pain referred from a non-ischaemic cardiac source is rare. We report a case of unilateral facial pain that occurred in relation to a large pericardial effusion and which resolved on drainage of the effusion.- - - - - - - - - - ranking = 0.023450512624232keywords = pain (Clic here for more details about this article) |
9/150. Emergency repair of incidentally diagnosed ascending aortic aneurysm immediately after caesarean section.A 36-yr-old pregnant woman with a history of hypertension presented at term for elective Caesarean section because of breech position. At preoperative examination, a diastolic murmur was found and transoesophageal echocardiography (TOE) revealed a large, 8.1-cm diameter ascending aortic aneurysm with severe aortic regurgitation and moderate pericardial effusion. Surgical repair was not considered to be urgently required. The patient was delivered electively by Caesarean section under epidural anaesthesia using invasive arterial pressure monitoring. TOE performed 6 h post-partum showed progressing pericardial effusion, for which emergency replacement of the aortic valve and ascending aorta were indicated. The epidural catheter was removed 4 h before starting the cardiopulmonary bypass procedure. arterial pressure was controlled by a titrated infusion of esmolol and clonidine. To improve uterine tone, the patient received an i.v. infusion of oxytocin throughout surgery. After implantation of an aortic composite graft and weaning from cardiopulmonary bypass, the patient was transferred to the intensive care unit. Awake and receptive to neurological evaluation, her trachea was extubated 4 h after surgery. Mother and baby made an uneventful recovery.- - - - - - - - - - ranking = 0.0011543305244663keywords = area (Clic here for more details about this article) |
10/150. Purulent pericarditis due to group B streptococcus and mycotic aneurysm of the ascending aorta: case report.A 61-year-old female, with a history of uterine and cervical cancer treated with radical hysterectomy and 2 years of postoperative chemotherapy, presented to the emergency department with dyspnea on exertion. Computed tomography of the chest revealed a large pericardial effusion and a sacciform aneurysm of the ascending aorta. The patient subsequently underwent emergency pericardiocentesis with drainage of approximately 330 ml of a bloody and turbid effusion. Cultures from the effusion yielded group B streptococcus. multiple organ failure and disseminated intravascular coagulation syndrome occurred in the acute phase, but gradually improved with continuous antibiotic therapy. On the 194th hospital day, in situ reconstruction of the ascending aorta was successfully performed using a synthetic graft. Although rarely reported, both purulent bacterial pericarditis and mycotic aneurysm can be life-threatening.- - - - - - - - - - ranking = 0.24681735922283keywords = chest (Clic here for more details about this article) |
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