- Massive pericardial effusion without cardiac tamponade due to subclinical hypothyroidism (Hashimoto's disease). [Journal Article]
- RRRural Remote Health 2018; 18(2):4384
- CONCLUSIONS: This was a rare case of an elderly female patient from a rural village with chronic massive pericardial effusion due to subclinical hypothyroidism without cardiac tamponade. Hypothyroidism should be included in the differential diagnosis of pericardial effusion, especially in a case of unexplained pericardial fluid. Initiation of hormone replacement therapy should be personalised in elderly patients. TSH levels >10 mU/L usually require therapy with levothyroxine in order to prevent adverse events. Rural patients usually do not have regular follow-up after the initiation of hormone replacement therapy. Pericardial effusions due to hypothyroidism grow slowly and subclinical hypothyroidism rarely shows signs and symptoms and can be underdiagnosed. The ESC position statement on triage strategy for pericardial diseases is a valuable clinical tool to estimate the necessity for pericardial drainage in such cases.
- [Fatal cardiac tamponade that developed in the post-anesthesia care unit: a rare complication after lung lobectomy]. [Journal Article]
- RBRev Bras Anestesiol 2018 May 15
- CONCLUSIONS: 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.
- Pyopericardium progressing to tamponade in a patient with immune thrombocytopenia. [Journal Article]
- BCBMJ Case Rep 2018 May 16; 2018
- Pericardial effusion can develop during any stage of pericarditis, and small effusions that appear rapidly can cause cardiac tamponade. Pyopericardium is a rare aetiology for tamponade. This is a cas...
Pericardial effusion can develop during any stage of pericarditis, and small effusions that appear rapidly can cause cardiac tamponade. Pyopericardium is a rare aetiology for tamponade. This is a case of an elderly diabetic lady, on steroid therapy for immune thrombocytopenia, who presented with fever and acute dyspnoea. She developed cardiac tamponade due to pyopericardium with Staphylococcus as the causative organism. Staphylococcus pyopericardium, in the absence of a primary focus of infection, progressing to tamponade is an uncommon scenario.
- Treatable massive pericardial effusion and hypertrophic cardiomyopathy in an infant with a novel homozygous ACADVL mutation: A case report. [Journal Article]
- MMedicine (Baltimore) 2018; 97(20):e10813
- CONCLUSIONS: This report highlights that genetic mutations should be investigated as possible causes of infantile-onset HCMP, and that early diagnosis and intervention can prevent mortality for patients with VLCAD deficiency.
- Thrombotic microangiopathy on kidney biopsy in a patient with TAFRO syndrome. [Journal Article]
- CCCEN Case Rep 2018 May 15
- TAFRO syndrome represents a characteristic constellation of symptoms comprising Thrombocytopenia, Anasarca, myeloFibrosis, Renal dysfunction, and Organomegaly, and is considered to be a clinicopathol...
TAFRO syndrome represents a characteristic constellation of symptoms comprising Thrombocytopenia, Anasarca, myeloFibrosis, Renal dysfunction, and Organomegaly, and is considered to be a clinicopathologic variant of idiopathic multicentric Castleman disease. A 51-year-old woman was admitted to the hospital complaining of abdominal distension. Findings on physical examination were indicative of anasarca. Computed tomography revealed mild splenomegaly, pericardial effusion, pleural effusion, ascites, and paraaortic lymphadenopathy. Blood tests showed thrombocytopenia, and urinalysis demonstrated hematuria, proteinuria, and worsening renal function. Kidney biopsy was performed and revealed thrombotic microangiopathy-like lesions with global sclerosis of 1 of the 16 glomeruli on light microscopy. The remaining glomeruli had a distinct lobular pattern, with mesangiolysis, double contours of the glomerular basement membranes, and marked endothelial swelling. Immunofluorescence studies for IgG, IgM, IgA, C1q, C3, C4, κ-light chains, and λ-light chains were indeterminate. Electron microscopy showed marked endothelial swelling. We made a diagnosis of TAFRO syndrome and started steroid treatment, following which her symptoms gradually improved. There are few reports describing renal pathology in a patient with TAFRO syndrome.
- Systemic sclerosis: severe pulmonary arterial hypertension and pericardial effusion at diagnosis. [Journal Article]
- BCBMJ Case Rep 2018 May 14; 2018
- A 51-year-old female patient with a recent hospital admission reported to the emergency room (ER) with progressive worsening of fatigue, dyspnoea and chest discomfort. She had been recently admitted ...
A 51-year-old female patient with a recent hospital admission reported to the emergency room (ER) with progressive worsening of fatigue, dyspnoea and chest discomfort. She had been recently admitted and discharged with the diagnosis of pericarditis and medicated with non-steroidal anti-inflammatory drugs and diuretics. She returned to the ER with persisting symptoms. Echocardiography was repeated and showed signs of elevated right ventricular systolic pressure and a slightly increased moderate/severe pericardial effusion without signs of cardiac tamponade. The patient was admitted and further evaluation confirmed an underlying case of advanced systemic sclerosis with skin, vascular, pulmonary and cardiac involvement. The patient was referred to specialised consults in autoimmune pathology and pulmonary arterial hypertension. She was started on bosentan and corticosteroids, presenting a favourable clinical evolution although symptoms of exertional dyspnoea persist.
- Mid-term outcomes from a multicenter study: Is TEVAR safe for ascending aortic dissection? [Journal Article]
- IJInt J Cardiol 2018 May 02
- CONCLUSIONS: TEVAR could be an effective alternative for high-risk patients. However, issues resulted from postoperative complications still call for attention.
- Percutaneous Retrieval of Implanted Leadless Pacemakers: Feasibility at 2.5 Years Post-Implantation in an In Vivo Ovine Model. [Journal Article]
- JCJACC Clin Electrophysiol 2015; 1(6):563-570
- CONCLUSIONS: We demonstrate the feasibility and safety of percutaneous, catheter-based retrieval in chronic LP implants of a maximum duration of approximately 2.5 years.
- Polyserositis: a diagnostic challenge. [Journal Article]
- IMIntern Med J 2018 May 14
- Polyserositis (PS) is the inflammation, with effusion, of different serous membranes. It has been associated with different aetiologiesbut the aetiology of PS remains unknown in a high percentage of ...
Polyserositis (PS) is the inflammation, with effusion, of different serous membranes. It has been associated with different aetiologiesbut the aetiology of PS remains unknown in a high percentage of patients. The general objective of this retrospective study was to analyse the aetiology of PS cases seen at Son Llàtzer Hospital in an eleven-year period. Other objectives were to determine epidemiological, clinical, and analytical characteristics of these patients. Ninety-two patients were included in the study. The most common diagnosis was neoplasm (nearly one third of cases) followed by infectious and autoimmune diseases. PS aetiology was unknown in more than one third. Pleura and pericardium were the most common sites of serosal involvement (83%). Antinuclear antibodies positivity in serum and increased levels of adenosine deaminase in pleural effusion were significantly associated with a final diagnosis of autoimmune disease. Increased pleural lactate dehydrogenase levels were significantly associated with a final diagnosis of neoplasm. In 9/14 patients with a previous cancer, PS represented a recurrence of their cancer. Cases of unknown aetiology presented most frequently as pleural and pericardial involvement and the majority resolved. In very few an infectious etiology could be proven. The most important limitations of the study are its retrospective design and the lack of a systematic work-up and a diagnosis algorithm for PS. This article is protected by copyright. All rights reserved.
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- Conservative management of nivolumab-induced pericardial effusion: a case report and review of literature. [Journal Article]
- EHExp Hematol Oncol 2018; 7:11
- CONCLUSIONS: With increasing use of immune checkpoint inhibitors, clinicians need to be aware of the unusual immune-related adverse events in order to provide timely management and effective patient care. To our knowledge, this is the first reported case of immune-related pericardial effusion from nivolumab successfully managed with high-dose corticosteroids. Furthermore, recurrent pericardial effusion was prevented by using low-dose corticosteroids as maintenance in order for patient to continue nivolumab treatment.