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]
Entire Body System
- Surgical Procedure
Articles include: Treatment of Aortic Aneurysms; Bariatric Surgical Procedures, Repeat Cesarean Deliveries; Thoracic and Cardiovascular Surgery; Abdominal and Pelvic Viscera; Abdominal, Pelvic Surgical and Post-procedural Foreign Bodies; Thorax; Kidneys [books.google.com]
During the surgical procedure the patient had a cardio-respiratory arrest, which was responsive to the resuscitation maneuvers. Methods: The clinical exam revealed left parasternal systolic murmur, with irradiation on the entire precordial area. [romanianjournalcardiology.ro]
Hybrid procedure includes combination vascular surgical procedure and endovascular stents. [pubs.sciepub.com]
In the literature the etiology of intrapericardial bleeding was attributable to pre-existing conditions or related to surgical procedure [ 1 - 3 ]. [omicsonline.org]
ATAAD repair and surgical rescue procedures The aortic repair procedures are detailed in previous studies reported from this institute [6,7]. [journals.plos.org]
- Ecchymosis
Examination of the chest did not reveal ecchymosis or evidence of trauma. The lungs were clear to auscultation, and cardiac exam revealed distant heart sounds. Peripheral pulses were palpable but weak. [ncbi.nlm.nih.gov]
Gastrointestinal
- Abdominal Distension
The patient presented with a 3-week history of weight gain, abdominal distension, and mild exertional dyspnea. [mdedge.com]
Cardiovascular
- 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]
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]
- Pulsus Paradoxus
However, collapses need not be present even in florid tamponade and particularly in some cases with chamber hypertrophy.2 Similarly, the absence of pulsus paradoxus correlates well with left ventricular hypertrophy.3 Moreover, the initially high blood [ahajournals.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]
Pulsus paradoxus was not assessed. Her BMI was 16. [clinmedjournals.org]
Detection of pulsus paradoxus associated with large pericardial effusions in pediatric patients by analysis of the pulse-oximetry waveform. Pediatrics. 2002;109:673–77. [PubMed] [Google Scholar] 13. Ariyarajah V, Spodick DH. [ncbi.nlm.nih.gov]
- Pericardial Friction Rub
He was febrile (39 oC), hypotensive, with low SpO2 and oliguria, without peripheral edema, hepatojugular reflux or pericardial friction rub. [scielo.org.mx]
Patient appeared euvolemic without pericardial knock or friction rub, gallop, murmur, jugular venous distention or peripheral edema. [jeccm.amegroups.com]
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]
- Continuous Murmur
Fistulae, VSD, and valvular disruption present with murmurs with or without evidence of left or right ventricular failure. Aorta-to–right heart fistulae produce continuous murmurs and right ventricular failure. [tele.med.ru]
Skin
- Ulcer
A ruptured ulcerative plaque through the intima to the adventitia without flap dissection in the ascending aorta was confirmed. The patient was discharged 18 days after the operation. [ncbi.nlm.nih.gov]
[…] with hemorrhage ( K26.0 ) acute gastritis with bleeding ( K29.01 ) ulcerative enterocolitis with rectal bleeding ( K51.01 ) pericardium, pericarditis I31.2 Pneumohemopericardium I31.2 ICD-10-CM Codes Adjacent To I31.2 I28.8 Other diseases of pulmonary [icd10data.com]
Can Assoc Radiol J 58: 22–26 PubMed Google Scholar Piffaretti G, Tozzi M, Lomazzi C et al (2007) Penetrating ulcers of the thoracic aorta: results from a single-centre experience. [link.springer.com]
Musculoskeletal
- Contusion
An hemopericardium and a cardiac contusion of the basal and posterior surface of the left ventricle were found to be the cause of the death. [ncbi.nlm.nih.gov]
Parasternal long axis view with curvilinear probe revealed more clearly pericardial effusion, cardiac contusion, and epicardial hematoma. [theultrasoundjournal.springeropen.com]
pulmonary complications - pneumothorax, hemothorax, lung contusions. [diki.pl]
S26.01 Contusion of heart with hemopericardium S26.01XA Contusion of heart with hemopericardium, init... S26.01XD Contusion of heart with hemopericardium, subs... S26.01XS Contusion of heart with hemopericardium, sequ... [icd10data.com]
Psychiatrical
- Fear
Fears, anger & sadness, emotions we typically have the most difficulty with, are commonly repressed while awake; allows function & interaction with others. [healthtap.com]
Urogenital
- Uremia
The 2 cases discussed below represent another example of hemorrhagic tendency associated with chronic uremia — namely, hemopericardium with cardiac tamponade. [nejm.org]
18% in acute uremia Other causes Serous fluid or transudate Congestive heart failure Hypoalbuminemia Irradiation Blood (hemopericardium) Rupture of ascending aorta or pulmonary trunk Coagulopathy Fibrin (produces exudate) Pyogenic infection, e.g. staph [learningradiology.com]
In the absence of uremia,5 this should have been a signal that something critical was afoot (we are not told the effect of atropine therapy, but it is likely to have been unsuccessful). [ahajournals.org]
In patients with severe renal dysfunction, DOACs can accumulate, increasing the likelihood of bleeding complications.13 Dysfunctional platelets due to uremia pose an additional bleeding risk. [acc.org]
Hemopericardium with cardiac tamponade in chronic uremia. New England J. Med. 1957; 257: 230 Scopus (13) PubMed Crossref Google Scholar Weiss S. Wilkins R.W. Myocardial abscess with perforation of the heart. Am. J. M. [ajconline.org]
Neurologic
- Confusion
This can prevent confusion that may even result in unwarranted intervention, if a “new” effusion is found unexpectedly during or after percutaneous epicardial access. [thoracickey.com]
Pons-Ferré b a Servicio de Cardiología, Hospital de Tortosa Verge de la Cinta, IISPV, Tarragona, Spain b Servicio de Anatomía Patológica, Hospital de Tortosa Verge de la Cinta, IISPV, Tarragona, Spain Article A 29-year-old man was hospitalized for headache, confusion [revespcardiol.org]
Because of the setting in which the diagnosis of cardiac trauma is considered, it is unlikely to be confused with other entities. Therefore, diagnostic problems revolve around identifying specific lesions that result from the traumatic event. [tele.med.ru]
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]
Workup
The infectious and inflammatory workup of pericardial fluid was negative, and the cause of hemopericardium was determined to be the micro-perforation of the ventricle from PPM lead which did not warrant lead revision. [shmabstracts.org]
Invasive diagnostic workup including surgery and histopathology, confirming the diagnosis angiosarcoma of the heart. [frontiersin.org]
It appears that all our patients experienced spontaneous hemopericardium while taking rivaroxaban as a thorough workup excluded other major etiologies. [clinmedjournals.org]
(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]
X-Ray
- Pericardial Effusion
Repeat TTE showed no re-accumulation of pericardial effusion. The patient recovered and was discharged in stable conditions with outpatient cardiology follow-up. [shmabstracts.org]
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]
When signs of pericardial effusion are manifested, patients often progress rapidly to CT (18). [jeccm.amegroups.com]
Moderate pericardial effusion without aortic valve regurgitation was disclosed on echocardiography. [jtcvs.org]
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]
Sec., Jiapu Road, Puzih City, Chiayi Country 613, Taiwan (ROC); qcth3160{at}adm.cgmh.org.tw Abstract Acute cardiac tamponade requires urgent diagnosis and treatment. [doi.org]
Operative treatment of aortic dissections. Experience with 125 patients over a sixteen-year period. [jtcvs.org]
Prognosis
Prognosis It depends upon associated anomalies and upon cardiac function. The prognosis of nonimmune fetal hydrops is very poor with a perinatal mortality rate between 70 to 90 percent1. Management Sonography must search for signs of heart failure. [thefetus.net]
CT scanning may be used to confirm the diagnosis but is less helpful in complications and prognosis. [patient.info]
With adequate therapy prognosis in patients with uremic hemopericardium can be good. This is supported by an 83 per cent survival during a mean follow-up of nineteen months. [amjmed.com]
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]
As a result, prognosis of cardiac angiosarcomas remains poor with survival ranging from 6 to 9 months after diagnosis (13). [frontiersin.org]
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 The etiology of hemopericardium in infants includes chest trauma either accidental or iatrogenic (i.e.: birth trauma, closed chest massage), generalized diathesis, pericardial teratomas, and rupture of cardiac aneurysms or diverticula2. [thefetus.net]
Hemopericardium: report of case of unknown etiology with recovery following two pericardial paracenteses. Review of etiology of hemopericardium. Am. Heart J. 1934; 9: 680 Scopus (1) Abstract Full Text PDF Google Scholar Fulton M.N. [ajconline.org]
Etiology There is a very long list of causes 1,2 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]
Epidemiology
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]
[…] 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]
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]
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]
Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end-stage renal disease: Insights and pathophysiology. Clin Cardiol 2017;40:839-46. [Crossref] [PubMed] De Pace NL, Nestico PF, Schwartz AB, et al. [jeccm.amegroups.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]
Understanding ventricular-vascular coupling helps in determining pathophysiology of cardiovascular manifestations [ 14 ]. [pubs.sciepub.com]
Prevention
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]
DOACs approved by the United States Food and Drug administration (FDA) include dabigatran (VTE treatment and prophylaxis, NVAF for stroke prevention),1 rivaroxaban (VTE treatment and prophylaxis, NVAF for stroke prevention, prevention of major adverse [acc.org]