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Mediastinopericarditis


Presentation

  • . mediastinopericarditis. // Taber's Cyclopedic Medical Dictionary;2005, p1318 A definition of the medical term "mediastinopericarditis" is presented.[connection.ebscohost.com]
  • Although occurrence of tuberculous mediastinopericarditis is rare at the present time in Japan, this disease has not been exterminated and should be kept in mind.[jstage.jst.go.jp]
  • Other possible presentations result from rupture, infection (see Figure 5 ), and hemorrhage (3,4).[rb.org.br]
  • Patient with large mediastinal mass they may present also with cardiac or respiratory arrest at initial or during anaesthesia.[omicsonline.org]
  • See Case 1: Shortness of Breath and Abdominal Pain Tuberculosis (TB) pericarditis is the most common pericardial disease in sub-Saharan Africa and may present as pericardial effusion, constrictive pericarditis, or effusive-constrictive pericarditis.(1,2[hivinsite.ucsf.edu]
Inflammation
  • […] mediastinopericarditis [ me″de-as″tĭ-no-per″ĭ-kar-di tis ] inflammation of the mediastinum and pericardium. me·di·as·tin·o·per·i·car·di·tis ( me'dē-as'tin-ō-per'i-kar-dī'tis ), Inflammation of the pericardium and of the surrounding mediastinal cellular[medical-dictionary.thefreedictionary.com]
  • Surgery will be required for more advanced cases. (15 Jan 1998) adhesive inflammation Inflammation in which the amount of fibrin in the exudate is sufficient to result in a slight or moderate degree of adherence of adjacent tissues, as in healing by first[kmle.co.kr]
  • . // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1420 A definition of the medical term "mediastinopericarditis" which refers to the inflammation of the mediastinum and pericardium is presented. mediastinopericarditis. // Taber's Cyclopedic[connection.ebscohost.com]
  • Typically, inflammation exists on a spectrum between serous inflammation or fibrinous inflammation, If bacteria are the root cause pericarditis then a pattern of supperative inflammation may result.[pathwaymedicine.org]
Physician
  • , American College of Physicians-American Society of Internal Medicine , American Society of Nephrology , and National Kidney Foundation Disclosure: Nothing to disclose.[medscape.com]
  • […] logo-32 logo-40 logo-60 New England Journal of Medicine NEJM Group Follow Us Facebook Twitter Instagram YouTube LinkedIn Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with NEJM Group information[nejm.org]
  • (Lower, 1672/1963) Lower rose to be one of the most eminent physicians of London. (Gotch, 1908) He was elected to the Royal College of Physicians, and enjoyed a period of great acclaim.[priory.com]
  • The oldest of seven children, both his grandfather and father being physicians, he was exposed to medicine from a young age.[j-pcs.org]
Collapse
  • Synonym: obliterative arachnoiditis. (05 Mar 2000) adhesive atelectasis Alveolar collapse in the presence of patent airways, especially when surfactant is inactivated or absent, especially in respiratory distress syndrome of the newborn, acute radiation[kmle.co.kr]
  • Recurrent pericardial effusion was observed twelve hours later without collapse.[cardiothoracicsurgery.biomedcentral.com]
  • 1) Trauma 2) Aortic dissection 3) AMI w/ rupture 4) Iatrogenic RA/RV collapse on ECHO, CO Signs and sx of cardiac tamponade Pulsus paradoxus - 10mmHg drop in diastolic pressure b/w inspiration and expiration Some special forms of pericardial effusion[studyblue.com]
  • As such, before induction, anesthesiologists should review a recent CT for all patients with mediastinal masses. 3 CT findings may indicate the need for rescue cardiopulmonary bypass or rigid bronchoscopy for control of hemodynamic or airway collapse.[anesthesiology.pubs.asahq.org]
  • The restricting pull of the adhesive bands at the apex of each deep inspiration creates a noteworthy and remarkable dilatation rather than collapse of the cervical veins, especially the jugular bulb.[rwjms1.umdnj.edu]
Weakness
  • A 39 year-old man was admitted to our hospital with chief complaints of dyspnea and weakness. Blood chemistry suggested the existence of congestive liver dysfunction.[jstage.jst.go.jp]
  • This creates a variety of problems which may include weakness of the peripheral muscles (usually worsening with repetitive contraction of the muscles), droopy eyelids (ptosis), double vision, and swallowing or breathing difficulties.[med.stanford.edu]
  • The heart tones were pure but weak; P2 was not accentuated. The neck veins were not especially distended... The disappearance of the pulse occurred during each inspiration...[rwjms1.umdnj.edu]
  • He didn't complain any myasthenic symtom like muscular weakness, fatigability, diplopia etc. and trauma in his previous history. The pulse was rapid and weak (142 beats/min), and the neck veins were distended.[cardiothoracicsurgery.biomedcentral.com]
  • S/S may exercise intolerance, weakness, fatigue, and systemic venous congestion. The treatment is aimed at relieving the constriction by removal of pericardium and administration of inotropic agents to improve cardiac contractibility. 12.[coursehero.com]
Congestive Heart Failure
  • Heart Failure Clinic, and ECG and Stress Testing Clinic, Brooke Army Medical Center G Shawn Lynchard, MD is a member of the following medical societies: American College of Cardiology and American College of Physicians Disclosure: Nothing to disclose[medscape.com]
  • […] systolic (congestive) heart failure I50.23 Acute on chronic systolic (congestive) heart failure I50.3 Diastolic (congestive) heart failure Excludes1: combined systolic (congestive) and diastolic (congestive) heart failure (I50.4-) I50.30 Unspecified[en.wikisource.org]
  • Its development correlates with the extent of necrosis, is more common with anterior than inferior infarcts, and is associated with a higher 1-year mortality rate as well as a higher incidence of congestive heart failure. 7 The diagnosis of post-MI pericarditis[clevelandclinicmeded.com]
  • heart failure (CHF)うっ血性心不全 constrictive pericarditis 収縮性心膜炎 continuous murmur連続[性]雑音 contractility収縮性、収縮能 contrast medium造影剤 cor心 cor pulmonale肺性心 coronary angiography (CAG) 冠[状]動脈造影[法] coronary angioplasty冠[状]動脈形成術 coronary artery冠[状]動脈 coronary artery[tokyo-med.ac.jp]
  • heart failure, unspecified Congestive heart disease Right heart failure (secondary to left heart failure) Excludes: fluid overload NOS (276.6) 428.1 Left heart failure Acute edema of lung with heart disease NOS or heart failure Acute pulmonary edema[theodora.com]
Pneumonia
  • […] arachnoiditis. (05 Mar 2000) adhesive atelectasis Alveolar collapse in the presence of patent airways, especially when surfactant is inactivated or absent, especially in respiratory distress syndrome of the newborn, acute radiation pneumonitis, or viral pneumonia[kmle.co.kr]
  • […] suppurative CaseousSerous pericarditis Mild inflammation with sterile serous effusion Causes noninfectious inflammatory diseases such as rheumatic fever, SLE, tumors, uremia infections contagious to the pericardium (upper respiratory tract infection, pneumonia[documents.tips]
  • Empyema is a suppurative infection of the pleural cavity that is usually related to extension of a necrotizing pneumonia or lung abscess.[clinicaladvisor.com]
  • In children, mediastinal masses are more likely to cause tracheobronchial compression and stridor or symptoms of recurrent bronchitis or pneumonia. Symptoms and signs also depend on location.[merckmanuals.com]
  • Example: Pneumonia, empyema, lung abscess, subphrenic abscess, liver abscess etc or during cardiotomy. Most common causative organisms are Staphylococci, Streptococci, and Pneumococci.[histopathology-india.net]
Mediastinal Disease
  • Mediastinal diseases are conditions that arise from tissues in this cavity.[utswmedicine.org]
  • Lymphadenopathy mediastinal - disease in the lymph nodes. Pericardial cysts which include growths that start in the lining of the heart. Tracheal tumors. Posterior mediastinal tumors include: Lymphadenopathy mediastinal - disease of the lymph nodes.[cedars-sinai.edu]
  • This sign is consistently a result of mediastinal disease, and we may only assume that it is mediastino-pericarditis when the history, onset, and course of the disease present as additional criteria for the diagnosis of pericarditis.[rwjms1.umdnj.edu]
  • This sign is consistently a result of mediastinal disease, and we may only assume that it is mediastino-pericarditis when the history, onset, and course of the disease present as additional criteria for the diagnosis of pericarditis.”[priory.com]
Respiratory Distress
  • Synonym: obliterative arachnoiditis. (05 Mar 2000) adhesive atelectasis Alveolar collapse in the presence of patent airways, especially when surfactant is inactivated or absent, especially in respiratory distress syndrome of the newborn, acute radiation[kmle.co.kr]
  • Patients with hypoxia and respiratory distress should be intubated and placed on mechanical ventilation. IV access should be established and intravenous antibiotics should be initiated without delay.[clinicaladvisor.com]
  • Chest radiograph of an infant in respiratory distress with a large air-filled bronchogenic cyst in the right chest. Arrow indicates inferior border of cyst. Chest radiograph of a child with a large right-sided bronchogenic cyst.[emedicine.medscape.com]
Painful Cough
  • Depending on the location, nature, and size of the tumor or mass, symptoms may develop due to pressure on organs inside the chest and may include: Chest pain Coughing Fever, chills, night sweats Shortness of breath Weight loss Wheezing Diagnosis If we[utswmedicine.org]
  • Chest pain, cough, dyspnea, myasthenia gravis, and weight loss are observed frequently in symptomatic patients. Pericardial effusion may be present in approximately 20% of cases.[cardiothoracicsurgery.biomedcentral.com]
Liver Dysfunction
  • Blood chemistry suggested the existence of congestive liver dysfunction. Chest X-ray film revealed marked cardiomegaly and a abnormal mass in the anteriorlysuperior area which was confirmed as anterior mediastinum on CT scan.[jstage.jst.go.jp]
Chest Pain
  • Symptomology The prototypical symptom of acute pericarditis is retrosternal chest pain which may also refer to the back and shoulders.[pathwaymedicine.org]
  • The most common symptoms are chest pain and weight loss. Lymphomas may manifest with fever and weight loss.[merckmanuals.com]
  • Pericardial effusion - the buildup of fluid in the sac Cardiac tamponade - a serious problem in which buildup of fluid in the sac causes problems with the function of the heart Symptoms of pericardial problems include chest pain, rapid heartbeat, and[coding-pro.com]
  • The patient, a 17-year-old male, presented with chest pain. A chest x-ray, computed tomography of the chest with contrast, and a CT-guided biopsy of the mass were performed preoperatively.[ctsnet.org]
Pulsus Paradoxus
  • (Kussmaul, 1873/2006) Pulsus Paradoxus: Modern Definition : The modern definition of pulsus paradoxus is the greater than 10 mm Hg inspiratory decline in systolic arterial pressure.[priory.com]
  • Clinically, systolic contraction of the ribcage and diaphragm and pulsus paradoxus may be observed. The increased workload may cause massive cardiac hypertrophy and dilatation, which can mimic an idiopathic cardiomyopathy.[medscape.com]
  • Keywords: Constrictive pericarditis, Kussmaul's sign, pulsus paradoxus How to cite this article: Singh N, Chadha DS, Bharadwaj P, Agarwal N. Adolf Kussmaul and Kussmaul's sign.[j-pcs.org]
  • paradoxus: Pulsus paradoxus is measured by careful auscultation with a blood pressure cuff.[odlarmed.com]
Hypertension
  • […] following medical societies: American College of Physicians , American Society of Hypertension , American Society of Nephrology , and International Society of Nephrology Disclosure: Nothing to disclose.[medscape.com]
  • hypertension NOS 459.31 Chronic venous hypertension with ulcer 459.32 Chronic venous hypertension with inflammation 459.33 Chronic venous hypertension with ulcer and inflammation 459.39 Chronic venous hypertension with other complication 459.8 Other specified[theodora.com]
  • […] primary) hypertension involving vessels of eye (H35.0) I11 Hypertensive heart disease [ edit ] Includes: any condition in I51.4-I51.9 due to hypertension I11.0 Hypertensive heart disease with heart failure Hypertensive heart failure Use additional code[en.wikisource.org]
  • There was mild pulmonary hypertension with a mean pulmonary artery pressure of 37 mm Hg and no significant rise with exertion. Figure 2.[circ.ahajournals.org]
  • Pediatric Neurological Emergencies 581 712 Clinical Findings 584 714 The Preterm Infant 585 715 The Term Infant 587 716 Congenital Infection 588 717 Acquired Infection 589 718 Nonaccidental Injury 590 719 Acute Disseminated Encephalomyelitis 592 7110 Hypertensive[books.google.com]
Pericardial Friction Rub
  • Signs The typical auscultory finding of pericarditis is the "Pericardial Friction Rub" which is observed as a high-pitched, scratching sound likely caused by the inflamed pericardial layers rubbing against one another.[pathwaymedicine.org]
  • Physical Pericarditis Pericardial friction rub: The most common and important physical finding is a pericardial friction rub, which is best heard at the lower left sternal border or apex when the patient is positioned sitting forward or on hands and knees[odlarmed.com]
  • - often idiopathic - SLE, tumors, uremia, viral - rheumatic fever Significance of fibrinous/serofibrinous fluid in pericarditis 1) serous fluid mixed w/ fibrinous exudate 2) seen w/ MI 3) assoc w/ pericardial friction rub -- Dressler's -- autoimmune,[studyblue.com]
  • Clinically, most striking feature is loud pericardial friction rub. c) Suppurative pericarditis - almost invariably denotes invasion by infective organisms which reach the pericardial cavity by several routes: direct extension from neighboring inflammation[medpreponline.com]
Cardiomegaly
  • Chest X-ray film revealed marked cardiomegaly and a abnormal mass in the anteriorlysuperior area which was confirmed as anterior mediastinum on CT scan. Echocardiogram disclosed a large. volume of pericardial effusion and thickened pericardium.[jstage.jst.go.jp]
  • Chest roentgenogram showed cardiomegaly, left pleural thickening but no remarkable pulmonary infiltration. Echocardiography showed massive pericardial effusion, ST-T change was shown on ECG.[webview.isho.jp]
  • Chest Radiography Cardiomegaly occurs if there is more than 250 mL of fluid in the pericardial sac ( Figure 7A ).[clevelandclinicmeded.com]
  • […] blood pressure without diagnosis of hypertension (796.2) pulmonary hypertension (416.0-416.9) that involving vessels of: brain (430-438) eye (362.11) 401.0 Malignant 401.1 Benign 401.9 Unspecified 402 Hypertensive heart disease Includes: hypertensive: cardiomegaly[theodora.com]
  • […] catheterization 心[臓]カテーテル法 cardiac cycle 心[臓]周期 cardiac death心臓死 cardiac index (CI)心係数 cardiac muscle ( myocardium)心筋 cardiac output 心拍出量 cardiac rupture心[臓]破裂 cardiac silhouette心陰影 cardiac standstill心静止 cardiac tamponade 心タンポナーデ cardiogenic shock 心原性ショック cardiomegaly[tokyo-med.ac.jp]
Suggestibility
  • Blood chemistry suggested the existence of congestive liver dysfunction. Chest X-ray film revealed marked cardiomegaly and a abnormal mass in the anteriorlysuperior area which was confirmed as anterior mediastinum on CT scan.[jstage.jst.go.jp]
  • CT may suggest the extent of disease providing clues as to how it interplays with the cardiopulmonary systems during induction of anesthesia. An 11-yr-old with facial swelling and lymphadenopathy provides an excellent example of these circumstances.[anesthesiology.pubs.asahq.org]
  • Kussmaul sign suggests impaired filling of the right ventricle due to a poorly compliant myocardium or pericardium.[en.wikipedia.org]
  • Low tissue velocity at both medial and lateral annuli suggests restriction.[clevelandclinicmeded.com]
  • The mass infiltrates into the mediastinum and encasing the aorta, which is causing extrinsic compression on the mediastinal structures with appearances suggestive of right sided heart strain.[omicsonline.org]

Workup

  • Close follow-up should be assured so that, if there is an inadequate response to therapy, alternative diagnoses can be considered and a more exhaustive diagnostic workup can be undertaken.[hivinsite.ucsf.edu]
Atelectasis
  • Synonym: obliterative arachnoiditis. (05 Mar 2000) adhesive atelectasis Alveolar collapse in the presence of patent airways, especially when surfactant is inactivated or absent, especially in respiratory distress syndrome of the newborn, acute radiation[kmle.co.kr]

Treatment

  • We believe this is only the second reported case of successful resolution of vulval herpetic adhesion using topical potent corticosteroid as the primary early treatment.[connection.ebscohost.com]
  • Your doctor will tailor your treatment to your type of mediastinal tumor. Talk to your doctor to get more accurate information about your prognosis.[healthline.com]
  • The specific treatment will depend on the type of tissue, its location, size, and the overall health of the patient.[utswmedicine.org]
  • Treatments Mediastinal tumors may be treated with surgery, chemotherapy and radiation or a combination of these options. The treatment will depend on the type of tumor, location and the overall health of the patient.[cedars-sinai.edu]
  • Without surgical treatment, biventricular failure develops.[clevelandclinicmeded.com]

Prognosis

  • Prognosis Patients with mediastinitis, empyema and purulent pericaditis should be treated with broad spectrum antibiotics, supportive care and surgical drainage. The prognosis depends on the timeliness of surgical intervention and treatment.[clinicaladvisor.com]
  • Because complete resection and the type of the tumor are the most important factors determining prognosis, the resection should be performed with regard to pathological evaluation for thymic enlargements as much as possible.[cardiothoracicsurgery.biomedcentral.com]
  • Talk to your doctor to get more accurate information about your prognosis.[healthline.com]
  • Prognosis The prognosis after resection of a mediastinal tumor varies widely, depending on the type of lesion resected. After resection of mediastinal cysts and benign tumors, the prognosis is generally excellent. [9] Donahue JM, Nichols FC.[emedicine.medscape.com]
  • In adults, pericarditis may not occur with myocardial or valvular involvement, and it is associated with a better prognosis. The pericarditis usually appears 7-10 days after the onset of fever and arthritis.[pkductin.vn]

Etiology

  • Overview Pericarditis can be caused by both infectious and noninfectious etiologies.[pathwaymedicine.org]
  • Additional diagnostic testing, usually imaging and biopsy, is indicated to determine etiology. CT with IV contrast is the most valuable imaging technique.[merckmanuals.com]
  • Etiology The most common form of acute pericarditis is idiopathic, which accounts for about 90% of cases ( Box 1 ).[clevelandclinicmeded.com]
  • International Although malignancy is the most common etiology of pericardial effusions in developed countries, tuberculosis should be considered in endemic areas.[odlarmed.com]

Epidemiology

  • […] incidence of TB pericarditis in patients with HIV infection and pericardial disease.(3,4) HIV testing often is readily available, even in resource-limited countries, and can increase the pretest probability of TB pericarditis significantly based on epidemiological[hivinsite.ucsf.edu]
  • Epidemiology Approximately 60,000 patients develop pleural infections in the United States each year. Between 40-60% of pneumonias will be associated with parapneumonic effusions.[clinicaladvisor.com]
  • Epidemiology A review of collected series reveals that many mediastinal neoplasms and masses vary in incidence and presentation depending on patient age.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • What is the pathophysiology of constrictive pericarditis? a. Healing of acute pericarditis may result in chronic (healed) pericardial dysfunction of two kinds: adhesive mediastinopericarditis and constrictive pericarditis .[coursehero.com]
  • Transposition of the Great Vessels (TGV) return to pathophysiology outlines return to pathophysiology return to home page[faculty.ccri.edu]
  • Pathophysiology [ edit ] Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity and the increased volume afforded to right ventricular expansion during diastole.[en.wikipedia.org]
  • It has unique clinical and pathophysiological features In contrast with systemic diffuse large B cell lymphoma, however identifying the gray-zone lymphoma is of paramount importance as highlighted by the WHO for diagnostic and therapeutic purposes.[omicsonline.org]
  • All of these are still used in the diagnostic assessment of patients despite the expansion of technology to confirm the diagnoses of pericardial tamponade, constrictive pericarditis, and metabolic acidosis. [2] , [3] Physiology and Pathophysiology The[j-pcs.org]

Prevention

  • These type of tumors cannot be prevented. Mediastinal Tumor Menu The mediastinum is divided into three sections What are mediastinal tumors? Tumors (also called neoplasms) are masses of cells. They can be benign (not cancer) or malignant (cancer).[my.clevelandclinic.org]
  • In constrictive pericarditis or restrictive cardiomyopathy, the restriction to diastolic filling of the RV is prevented by the fixed, less compliant constricting pericardium or myocardium, respectively.[j-pcs.org]
  • This could be demonstrated also at the carotid arteries as well as the radials: palpation of the femoral arteries was prevented by the edema. Respirations were between 27 and 30 and on exertion rose to and over 40 per minute.[rwjms1.umdnj.edu]
  • Mortality/Morbidity The early diagnosis of significant pericardial and cardiac injuries can prevent morbidity and enhance survival.[odlarmed.com]

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