- Polymicrobial bacterial pericarditis and cardiac tamponade caused by pericardial penetration of an adjustable gastric band. [Journal Article]
- BCBMJ Case Rep 2018 Feb 16; 2018
- We describe a case of polymicrobial bacterial pericarditis withKlebsiella pneumoniaeandProteus mirabilis, caused by pericardial penetration of the tip of the catheter of a laparoscopic adjustable gas...
We describe a case of polymicrobial bacterial pericarditis withKlebsiella pneumoniaeandProteus mirabilis, caused by pericardial penetration of the tip of the catheter of a laparoscopic adjustable gastric band (LAGB). The patient developed a cardiac tamponade, and subsequently emergency pericardiocentesis was performed. Analysis of earlier CT scans showed that the tip of the catheter had migrated through the liver and through the diaphragm into the pericardium, and was in contact with the myocardium. After stabilisation he was operated to remove the LAGB. In this case report, we describe the chain of events that led to the polymicrobial pericarditis-a complication of LAGB placement that to our knowledge has thus far never been reported. We furthermore present a detailed literature review of all published cases of polymicrobial pericarditis and its causes.
- Safety and Feasibility of a Novel Active Fixation Temporary Pacing Lead. [Journal Article]
- JIJ Invasive Cardiol 2018 Feb 15
- CONCLUSIONS: This first-in-human study demonstrates the safety and technical feasibility of the Tempo lead, providing stable periprocedural temporary pacing support.
- Acute pericarditis following endoscopy. [Journal Article]
- BCBMJ Case Rep 2018 Feb 05; 2018
- The differential diagnoses for patients presenting with chest discomfort after endoscopy remain broad. In addition to infectious, traumatic and bleeding complications, intrinsic cardiac pathology sho...
The differential diagnoses for patients presenting with chest discomfort after endoscopy remain broad. In addition to infectious, traumatic and bleeding complications, intrinsic cardiac pathology should be considered. Though rare, pericarditis and pericardial tamponade are additional entities that the clinician should consider when evaluating these patients. We present a 74-year-old man who arrived to the emergency department with substernal chest discomfort that began shortly after upper and lower endoscopy the previous day. Biopsies were obtained during the procedure (ileal and colonic mucosa) without complication. The patient reported worsening chest discomfort with deep inspiration or lying flat. ECG was significant for diffuse ST-segment elevation and PR depression. Cardiac workup was otherwise negative; the patient improved with conservative measures. In this case report, we describe a little known complication after upper endoscopy. By highlighting the clinical features of pericarditis in this setting, the provider can be alert to recognise and promptly treat this clinical entity.
- Feasibility and safety of outpatient cardiac catheterization with intracoronary acetylcholine provocation test. [Journal Article]
- HVHeart Vessels 2018 Feb 12
- Intracoronary acetylcholine (ACh) provocation test is useful to diagnose vasospastic angina. Although outpatient coronary angiography has been widely performed in current clinical settings, the feasi...
Intracoronary acetylcholine (ACh) provocation test is useful to diagnose vasospastic angina. Although outpatient coronary angiography has been widely performed in current clinical settings, the feasibility and safety of ACh provocation test in outpatient services are unclear. A total of 323 patients, who electively underwent ACh provocation test in hospitalization and outpatient services, were included. Coronary angiography was performed after insertion of a temporary pacing electrode in the right ventricle. The positive diagnosis of intracoronary ACh provocation test was defined as total or subtotal coronary artery narrowing accompanied by chest pain and/or ischemic electrocardiographic changes. Cardiac complications defined as composite of death, ventricular fibrillation or sustained ventricular tachycardia, myocardial infarction, cardiogenic shock, and cardiac tamponade, were evaluated. There were 201 patients (62%) in the hospitalization group and 122 patients (38%) in the outpatient group. The incidence of positive ACh provocation test was similar between the 2 groups (47 vs. 54%, p = 0.21). Coronary angiography in the outpatient group was performed through the radial artery, mostly (98%) with a 4 F sheath. Venous access site was not significantly different between the 2 groups, and the sheath size was 5 F in all cases. There were 2 cases (1.0%) of cardiac complications in the hospitalization group, whereas 1 case (0.8%), which led to unexpected hospitalization, occurred in the outpatient group. In conclusion, intracoronary ACh provocation test for the diagnosis of vasospastic angina in outpatient services was feasible and safe in selected patients.
- Sheehan's syndrome presenting as cardiac tamponade. [Journal Article]
- BCBMJ Case Rep 2018 Feb 03; 2018
- A 50-year-old woman presented with progressive dyspnoea and oedema with rapid deterioration over the last few days. Clinical examination revealed hypotension with cold clammy skin, raised jugular ven...
A 50-year-old woman presented with progressive dyspnoea and oedema with rapid deterioration over the last few days. Clinical examination revealed hypotension with cold clammy skin, raised jugular venous pressure and muffled heart sounds and was diagnosed to have cardiac tamponade, later confirmed on two-dimensional echocardiography. However, patient had bradycardia, and the other striking examination findings were coarse facies with pallor, madarosis, absent axillary and pubic hair and breast atrophy. Her blood sugar level was also low. Detailed history revealed an episode of postpartum haemorrhage with lactation failure and early menopause. Pericardiocentesis was done with a pig-tail catheter. Hormone profile and MRI brain confirmed the diagnosis of Sheehan's syndrome. Patient improved on treatment with thyroxine and hydrocortisone supplementation and was discharged with education about stress dosing.
- A Life-Threatening Bronchogenic Cyst. [Journal Article]
- KJKorean J Thorac Cardiovasc Surg 2018; 51(1):69-71
- A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emerge...
A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left a trium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.
- Cardiac tamponade communicating with a posterior mediastinal chylocele after esophagectomy. [Journal Article]
- JSJ Surg Case Rep 2017; 2017(10):rjx216
- A 75-year-old male received neoadjuvant chemotherapy for locally advanced squamous cell carcinoma of the mid-thoracic esophagus, followed by right transthoracic esophagectomy with extended mediastina...
A 75-year-old male received neoadjuvant chemotherapy for locally advanced squamous cell carcinoma of the mid-thoracic esophagus, followed by right transthoracic esophagectomy with extended mediastinal lymphadenectomy. Cardiac tamponade developed on postoperative Days 1 and 13, for which emergency ultrasound-guided drainage was required. Pericardial drainage fluid became chylous after administration of polymeric formula. A computed tomography scan demonstrated the presence of a retrocardiac fluid collection, encompassed by the left pulmonary vein and left atrium, descending aorta and vertebral column. Based on these findings, the diagnosis of chylopericardial tamponade communicating with a posterior mediastinal chylocele was made. The ligation of the thoracic duct was successfully performed via the left-sided thoracoscopic approach on postoperative Day 20 and the clinical course after the second operation was uneventful. The possible mechanisms of this exceptionally rare complication after esophagectomy were discussed.
- Comparison of In-hospital Outcomes Between Transcatheter and Surgical Aortic Valve Replacement in Patients with Aortic Valve Stenosis: A Retrospective Cohort Study Using Administrative Data. [Journal Article]
- JCJ Cardiothorac Vasc Anesth 2017 Jun 30
- CONCLUSIONS: This large-scale multicenter comparative analysis of TAVI and SAVR in Japan indicated that TAVI produced better clinical outcomes in patients with aortic valve stenosis. The improved outcomes were particularly notable in patients aged 80 years or older.
- Impact of a negative D-dimer result on the initial assessment of acute aortic dissection. [Journal Article]
- IJInt J Cardiol 2018 Jan 31
- CONCLUSIONS: We found that high platelet count and low extension score were independent factors related to a negative D-dimer result. Even if the length of the dissection is short, an emergency operation is necessary in some patients with a negative D-dimer result. Physicians should recognize that a negative D-dimer result alone cannot exclude patients with fatal AAD conditions.
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- Clinical differences between men and women undergoing surgery for acute Type A aortic dissection. [Journal Article]
- ICInteract Cardiovasc Thorac Surg 2018 Feb 06
- CONCLUSIONS: No differences were observed in both early and long-term mortality between women and men. Male patients had a significantly higher rate of reoperation.