Presentation
We present a case of chylopericardium presenting as cardiac tamponade after a median sternotomy for mechanical aortic valve replacement. [ncbi.nlm.nih.gov]
Entire Body System
- Asymptomatic
We conclude that if a patient is asymptomatic and can well tolerate daily life, surgery including pericardiectomy or ligation of the thoracic duct is not necessarily required. [ncbi.nlm.nih.gov]
Abstract We report idiopathic chylopericardium in a physically active, asymptomatic 29-year-old man. Preoperative diagnosis was made by external cardiac imaging after oral administration of 131l-labeled triolein. [acpjournals.org]
- Pain
Idiopathic Ligation of the thoracic duct and the creation of a pericardial window 1 week N/A Rivera-Beltran et al. [15] 16Y Male Intermittent chest pain and dizziness Idiopathic Pericardiocentesis; MCT-rich diet; Octreotide; transabdominal ligation of [bmcpediatr.biomedcentral.com]
Patients may experience pain of varying severity in areas around the effected bone. [en.wikipedia.org]
When enough fluid accumulates, affected individuals will have poor heart function, which can lead to difficulty breathing, chest pain, and a fast heart rate. If this condition is not treated it can become life threatening. [chop.edu]
In April 1992 a healthy 22-year-old woman was admitted on an emergency basis with a 5-day history of progressive breathlessness after an episode of pericardial pain that had resolved spontaneously. On examination she had signs of cardiac tamponade. [jtcvs.org]
- Turkish
Şafak Hospital, İstanbul 3Department of Radiology, Avrupa Şafak Hospital, İstanbul 4Department of Anaesthesiology and Reanimation, Avrupa Şafak Hospital, İstanbul 5Department of Cardiology, Medicine Faculty of Dumlupınar University, Kütahya Abstract Turkish [tgkdc.dergisi.org]
[…] of Turkish conflict of laws. [turkiyeklinikleri.com]
Chylothorax: Literature review and two rare cases Turkish Respir J. 2008;9:56–60 14. Browse NL, Allen DR, Wilson NM. Management of chylothorax Br J Surg. 1997;84:1711–6 15. [journals.lww.com]
Turkish Respir J 2008;9:56-60. 14. Browse NL, Allen DR, Wilson NM. Management of chylothorax. Br J Surg 1997;84:1711-6. [ PUBMED ] 15. Densupsoontorn N, Jirapinyo P, Wongarn R, Thamonsiri N, Nana A, Laohaprasitiporn D, et al. [lungindia.com]
Respiratoric
- Cough
Pericardial drainage. 15 days No recurrence Lope-castilla et al. [17] 2 M Male Dyspnea and anorexia Idiopathic Pericardiocentesis; Pericardial drainage and low-fat total parenteral nutrition enriched with MCT 36 days No recurrence Tan et al. [18] 5Y Male Cough [bmcpediatr.biomedcentral.com]
We report the case of a 5-year-old male child who presented with cough and dyspnoea. Bulging of the chest wall and distant heart sounds suggested the diagnosis of a pericardial effusion, which was confirmed on a chest computed tomography. [ncbi.nlm.nih.gov]
Case A 42 year old man presented with 6 years of cough with bronchial casts (Figure 1A). Workup revealed a moderately-sized pericardial effusion and multifocal infiltrates on CT (Figure 1B-C). [jacc.org]
Gastrointestinal
- Vomiting
Investigations specifically looking for malignant disease, lymphoma, and tuberculosis should be carried out.14,15 A history of trauma caused by thoracic surgery or blunt injury, the introduction of subclavian venous catheters, or episodes of vomiting [ncbi.nlm.nih.gov]
In closed tear duct injuries can occur through different pathogenic mechanisms: hyperextension of the spine especially when the duct is fixed by the pathological process and is full-postprandial-rupture occurs above the diaphragm; effort vomiting, coughing [medicaldb.blogspot.com]
- Nausea
She denied any orthopnea, paroxysmal nocturnal dyspnea, diaphoresis, palpitations, nausea, vomiting, or abdominal or lower extremities swelling. [jacc.org]
The patient represented on the 12 th post operative day with increasing shortness of breath, accompanied by nausea and vomiting. Chest x-ray showed gross cardiomegaly (fig 1 ). [cardiothoracicsurgery.biomedcentral.com]
When they do occur, symptoms include abdominal pain and/or distension; nausea, vomiting, diarrhea; decreased appetite and malnourishment. [en.wikipedia.org]
Cardiovascular
- Thrombosis
SVC thrombosis complicated by chylothorax and chyolpericardium can be a rare presenting initial symptom of BD. [ncbi.nlm.nih.gov]
Reference Age Gender Symptoms and signs Etiology Treatment Duration Prognosis Suri et al. [16] 4Y Female Orthopnea, anasarca, tachycardia, tachypnea, pulsusparadoxus, engorged neck vein, muffled heart sound Superior vena cava thrombosis Heparin infusion [bmcpediatr.biomedcentral.com]
Effort- induced thrombosis of the subclavian vein a case of Paget-Schroetter syndrome. Ulster Med J 2004; 3: 5-6. 14 Mogulkoc N, Onal B, Okyay N, Gunel O, Bayindir U. [thieme-connect.com]
Neurologic
- Irritability
Unlike pleural effusion, Chile pahipleurita not cause irritation, also has the tendency to fistulization cloazonare or chest wall. [medicaldb.blogspot.com]
Two days later the child was found to be in respiratory distress, irritable with profuse sweating and dysphagia. Chest X-ray revealed cardiomegaly. [jpma.org.pk]
Because chyle may be a pericardial irritant, constrictive pericarditis may eventually develop. [wikidoc.org]
In addition, cardiac complications can occur including cardiac tamponade and, since chyle appears to be a pericardial irritant, acute pericarditis or constrictive pericarditis may also result [1,20]. [medilib.ir]
Workup
Workup revealed a moderately-sized pericardial effusion and multifocal infiltrates on CT (Figure 1B-C). Infectious and autoimmune workup were negative with only an elevated triglyceride level to 436. [jacc.org]
The laboratory workup revealed hemoglobin 18 g/dL, leukocytes 6.4, glucose 73 mg/dL, creatinine 1.1 mg/dL, and C-reactive protein 62.2 mg/dL. The echocardiogram showed severe pericardial effusion. [revespcardiol.org]
[…] histological features of lung specimens from nine patients in whom no extrathoracic lesions were identified, which they termed "diffuse pulmonary lymphangiomatosis" (DPL). [4] Recognition of the disease requires a high index of suspicion and an extensive workup [en.wikipedia.org]
X-Ray
- Pericardial Effusion
|Chronic effusive pericarditis (disorder)|Chronic pericarditis with effusion|Chylopericardium|Chylopericardium (disorder)|Congenital pericardial effusion|Congenital pericardial effusion (disorder)|Pericardial effusion|Pericardial effusion (disorder)|Pericardial [averbis.com]
Medical treatment includes a low-fat diet with medium-chain triglyceride restriction, cardiac support, diuretic medications, and drainage of the pericardial effusion. [mayoclinic.pure.elsevier.com]
Echocardiography revealed a large pericardial effusion. A specific diagnosis of chylopericardium was made by pericardiocentesis and analysis of the fluid. [ncbi.nlm.nih.gov]
Other causes of pericardial effusion and pericarditis are discussed separately. (See "Etiology of pericardial disease" and "Diagnosis and treatment of pericardial effusion", section on 'Etiology'.) [medilib.ir]
Treatment
Treatment is dependent on the etiology. Surgical management is the most successful. [ncbi.nlm.nih.gov]
Prognosis
Reference Age Gender Symptoms and signs Etiology Treatment Duration Prognosis Suri et al. [16] 4Y Female Orthopnea, anasarca, tachycardia, tachypnea, pulsusparadoxus, engorged neck vein, muffled heart sound Superior vena cava thrombosis Heparin infusion [bmcpediatr.biomedcentral.com]
Differentiation of Chylopericardium from other Disorders Cholesterol pericarditis Natural History, Complications, Prognosis Infection, tamponade, or constriction may aggravate the prognosis. [wikidoc.org]
[…] than does multi-organ involvement; the combination of pleural and peritoneal involvement with chylous effusions and lytic bone lesions carries the least favorable prognosis. [16] When lung involvement is suspected, high resolution computed tomography [en.wikipedia.org]
Surgical management is the most successful treatment and is associated with a favorable prognosis. [spandidos-publications.com]
Primary isolated chylopericardium unrelated to trauma is rare, and we could find only 31 case reports since 1954., ,, ,, ,, , The prognosis is poor without treatment, but once diagnosed, thoracic duct ligation and a partial pericardiectomy result in complete [journal.chestnet.org]
Etiology
Treatment is dependent on the etiology. Surgical management is the most successful. [ncbi.nlm.nih.gov]
(See "Etiology, clinical presentation, and diagnosis of chylothorax".) [medilib.ir]
Reference Age Gender Symptoms and signs Etiology Treatment Duration Prognosis Suri et al. [16] 4Y Female Orthopnea, anasarca, tachycardia, tachypnea, pulsusparadoxus, engorged neck vein, muffled heart sound Superior vena cava thrombosis Heparin infusion [bmcpediatr.biomedcentral.com]
Epidemiology
Epidemiology [ edit ] Lymphangiomatosis can occur at any age, but the incidence is highest in children and teenagers. [en.wikipedia.org]
Pathophysiology
Although the exact pathophysiology of primary chylopericardium has not been established, the reflux of chylous fluid into the pericardial space was suggested as the etiology. [ncbi.nlm.nih.gov]
This highly acclaimed text offers ICU clinicians a new understanding of the pathophysiology of critical illness and new therapeutic approaches to critical care. [books.google.com]
The pathophysiology of isolated postoperative chylopericardium is still uncertain. [e-sciencecentral.org]
Explaining the pathophysiology of primary chylopericardium is not simple. [revespcardiol.org]
Prevention
The inflammatory process may have caused fibrin production and tissue adhesion in the pericardial cavity, and these might have prevented an accumulation of chyloid fluid and occluded the connection between the thoracic duct and the pericardial cavity. [ncbi.nlm.nih.gov]
The patient should be evaluated rapidly to prevent the complications of this disease. [link.springer.com]
Pericardiectomy is effective in preventing recurrences, but post-operative myocardial hernias are life-threating complications. On the other hand, open or VATS pleuro-pericardial window is a simple procedure but with a high risk of relapse. [oatext.com]
Thoracic duct ligation and pericardial window formation are believed to be the most effective procedures to prevent recurrence. [7], [9] In our experience, we tried pericardial window formation in both patients; however, first patient showed resolution [jiaps.com]