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Hemopericardium


Presentation

  • A significant number of patients present in a subacute fashion and can be successfully treated with surgery if diagnosed promptly. We present a case of subacute free-wall rupture that occurred after an undiagnosed myocardial infarction.[ncbi.nlm.nih.gov]
  • The present case demonstrates hemopericardium caused by a mobile retained EPW. A 49-year-old woman presented to our emergency department with clinical signs of impending cardiac tamponade.[ncbi.nlm.nih.gov]
  • The intra-pericardial paraganglioma is very rare and most of them present with hypertension or palpitations.[ncbi.nlm.nih.gov]
  • Pulmonary artery aneurysm presenting with dissection and hemopericardium is extremely rare, and we came across one such case in our center. The patient was a 22-year-old man who presented with dyspnoea, tachypnoea, and pallor.[ncbi.nlm.nih.gov]
  • We report a patient with hemophilia B who presented with spontaneous hemopericardium and tamponade requiring emergent pericardiocentesis.[ncbi.nlm.nih.gov]
Hypoxemia
  • The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain.[ncbi.nlm.nih.gov]
Abdominal Obesity
  • External examination was unremarkable except for abdominal obesity. Internal examination revealed 500 cc of liquid and clotted blood in the pericardial cavity. A lateral left ventricular wall aneurysm with associated mural thrombus was also noted.[scholarworks.wmich.edu]
Hypotension
  • Massive bleeding through the chest drains with hypotension required emergency reoperation in the intensive care unit. The patient was discharged home on postoperative day 11.[ncbi.nlm.nih.gov]
  • The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain.[ncbi.nlm.nih.gov]
  • The patient had a large hyperdense pericardial effusion caused by accumulation of bloody fluid, leading to hypotension and shock. Approximately 1000 mL of hemorrhagic fluid was drained from the pericardial space.[ncbi.nlm.nih.gov]
  • In the field she was hypotensive and responded to vigorous fluid resuscitation. At the trauma center, initial chest radiography ( Fig. 1A ) showed enlargement of the superior mediastinum.[doi.org]
  • Nineteen (35%) were hypotensive on arrival or during initial resuscitation. Most received surgeon-performed focused cardiac ultrasound examinations (n 43, 78%) with positive results (n 25, 58%).[ncbi.nlm.nih.gov]
Pulsus Paradoxus
  • paradoxus. [6] Treatment [ edit ] When discovered, hemopericardium is usually treated by pericardiocentesis, a procedure wherein a needle is used to remove the fluid from the pericardial sac. [6] This procedure typically utilizes an 8-cm, 18-gauge needle[en.wikipedia.org]
  • At admission, the heart rate was 112 bpm, and the patient had elevated jugular venous pressure, pulsus paradoxus, and distant heart sounds on auscultation.[academic.oup.com]
  • paradoxus Decrease in systolic pressure with inspiration of more than 10 mm Hg Rate of accumulation of fluid is proportional to severity of symptoms The faster the fluid accumulates, the more severe the symptoms Requires about 150-250cc before cardiac[learningradiology.com]
  • Other symptoms and signs may include the following: Elevated jugular venous pressure Pulsus paradoxus Chest pressure Decreased urine output Confusion Dysphoria See Clinical Presentation for more detail.[emedicine.medscape.com]
Pericardial Friction Rub
  • Signs of pericardial involvement such as a pericardial friction rub, jugular venous distension or a paradoxical pulse suggest that surgical intervention may be required.[patient.info]
Narrow Pulse Pressure
  • While on bypass, progressive hemopericardium led to narrow pulse pressure and decreased venous return that limited bypass flow. Widened cardiac silhouette on chest radiographs suggested hemopericardium; echocardiography was confirmatory in one case.[ncbi.nlm.nih.gov]

Workup

  • (See Presentation, Workup, Treatment, and Medication .) This anteroposterior-view chest radiograph shows a massive, bottle-shaped heart and conspicuous absence of pulmonary vascular congestion. Reproduced with permission from Chest, 1996: 109:825.[emedicine.medscape.com]
Pericardial Effusion
  • Effusive-constrictive pericarditis is an uncommon disorder characterised by symptoms of refractory cardiac failure, thickening of the visceral pericardium and pericardial effusion, with no improvement after pericardiocentesis.[ncbi.nlm.nih.gov]
  • Review of previous echocardiograms showed a 4 mm echo-free space, epicardial fat or pericardial effusion.[ncbi.nlm.nih.gov]
  • She was diagnosed with pericardial effusion leading to cardiac tamponade. Pericardiocentesis and thoracentesis procedures removed a cumulative total of 2000 mL of bloody fluid.[ncbi.nlm.nih.gov]
  • From Wikidata Jump to navigation Jump to search pericardial effusion that results from blood in the pericardial sac Haemopericardium hemopericardium edit English hemopericardium pericardial effusion that results from blood in the pericardial sac Haemopericardium[wikidata.org]
  • One month after starting the drug, an incidental finding of a small pericardial effusion was found on echocardiography.[ncbi.nlm.nih.gov]

Treatment

  • We report successful treatment of man with acute spinal cord injury who presented with simultaneously diagnosed PTE and hemopericardium, a rare complication involving two distinct and opposing pathological mechanisms and conflicting treatments.[ncbi.nlm.nih.gov]
  • Because cardiac injury by the EPW was suspected, the patient was transferred to another medical center for further treatment.[ncbi.nlm.nih.gov]
  • To describe 2 cases of hemopericardium following treatment with dabigatran. A 70-year-old male with a history of dabigatran use presented with cough, fatigue, and bloody stools.[ncbi.nlm.nih.gov]
  • Four novel oral anticoagulant agents are currently available for the prevention and treatment of thromboembolic events in patients with nonvalvular atrial fibrillation.[ncbi.nlm.nih.gov]
  • We report the clinical course and successful surgical treatment of hemopericardium resulting from coronary artery (CA) laceration in two patients with congenital diaphragmatic hernia (CDH) undergoing extracorporeal membrane oxygenation (ECMO) bypass.[ncbi.nlm.nih.gov]

Prognosis

  • CT scanning may be used to confirm the diagnosis but is less helpful in complications and prognosis.[patient.info]
  • Prognosis Cardiac tamponade is a medical emergency. The prognosis depends on prompt recognition and management of the condition and the underlying cause of the tamponade. Untreated, cardiac tamponade is rapidly and universally fatal.[emedicine.medscape.com]
  • [Meta-analysis of the prognosis of thoracic aortic dissection: changing mortality in the last four decades]. Herz. 1992;17:398-416. Razavi M. Acute dissection of the aorta: options for diagnostic imaging. Cleve Clin J Med. 1995;62:360-365.[path.upmc.edu]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • In conclusion, if hemopericardium is present without clear etiology in a patient with a retained EPW, a nearby mobile EPW may be the cause.[ncbi.nlm.nih.gov]
  • Etiology There is a very long list of causes 1,4 but some of the more common are: ruptured myocardial infarction ruptured left ventricular aneurysm aortic dissection pericarditis trauma blunt/penetrating/deceleration iatrogenic, e.g. pacemaker wire insertion[radiopaedia.org]
  • In the literature the etiology of intrapericardial bleeding was attributable to pre-existing conditions or related to surgical procedure [ 1 - 3 ].[omicsonline.org]
  • Etiology For all patients, malignant diseases are the most common cause of pericardial tamponade.[emedicine.medscape.com]

Epidemiology

  • […] patients undergoing heart valve surgery, cardiac tamponade has been associated with any amount of pericardial effusion at the first postoperative transthoracic echocardiography as well as with mechanical valve replacement of the aortic or mitral valve. [9] Epidemiology[emedicine.medscape.com]
  • Epidemiology The incidence is approximately 3-4 per 100,000 per year. [ 2 ] Aortic dissection is the most common emergency affecting the aorta. The male:female ratio varies - in one study, almost 70% of cases were in males.[patient.info]
  • View Article PubMed Google Scholar Carbone M, Fisher S, Powers A, Pass HI, Rizzo P: New molecular and epidemiological issues in mesothelioma: role of SV40. J Cell Physiol. 1999, 180: 167-72. 10.1002/(SICI)1097-4652(199908)180:2 3.0.CO;2-Q.[diagnosticpathology.biomedcentral.com]
Sex distribution
Age distribution

Pathophysiology

  • Acute aortic syndrome, including classic aortic dissection, intramural aortic hematoma, and penetrating atherosclerotic ulcer (PAU), is a term used to describe a group of conditions with similar clinical symptoms, but with different pathophysiological[ncbi.nlm.nih.gov]
  • Understanding ventricular-vascular coupling helps in determining pathophysiology of cardiovascular manifestations [ 14 ].[pubs.sciepub.com]
  • Timetable, The Little Hall 08:00 – 08:50 Registration, coffee 08:55 – 09:00 Welcome and introduction Indrek Rätsep 09.00 – 09.30 A systematic Echo approach to cardiovascular pathophysiology.[baltanest2016.com]
  • (See Pathophysiology, Etiology, and Prognosis .) The overall mortality risk depends on the speed of diagnosis, the treatment provided, and the underlying cause of the tamponade.[emedicine.medscape.com]
  • Patients may demonstrate the pathophysiologic patterns of tamponade (see Chapter 19), left ventricular failure, right ventricular failure, acute VSD (see Chapter 15), acute valvular regurgitation (see Chapter 16), or MI.[tele.med.ru]

Prevention

  • Four novel oral anticoagulant agents are currently available for the prevention and treatment of thromboembolic events in patients with nonvalvular atrial fibrillation.[ncbi.nlm.nih.gov]
  • Given her CHA2DS2VASc score of 3, she was started on warfarin for stroke prevention. One month later, she was admitted with cardiac tamponade.[ncbi.nlm.nih.gov]
  • Apixaban, a direct factor Xa inhibitor, is a novel oral anticoagulant (NOAC) indicated for prevention of embolic events in patients with nonvalvular atrial fibrillation.[ncbi.nlm.nih.gov]
  • Rivaroxaban is a novel anticoagulant approved for use in patients with atrial fibrillation for stroke prevention. It is a factor Xa inhibitor, and its activity cannot be monitored with use of the international normalized ratio.[ncbi.nlm.nih.gov]
  • Dabigatran etexilate is a new oral anticoagulant used for the prevention of systemic thromboembolism in patients with atrial fibrillation.[ncbi.nlm.nih.gov]

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