Presentation
Presents 49 fully illustrated case presentations with teaching points that make information easy to understand and digest. [books.google.com]
This review describes the pathology, clinical presentation, and treatment of both benign and malignant tumors of both the heart and the pericardium. [journals.lww.com]
When present, signs and symptoms are generally nonspecific. Patients often present with dyspnea, chest pain, palpitations, fever, or weight loss. [ncbi.nlm.nih.gov]
Fulminant clinical tamponade presents with symptoms that depend on its etiology. [textbookofcardiology.org]
Entire Body System
- Fever
Dyspnea / tachypnea Cough and dysphagia Malignancy associated pericarditis: fever, night sweats, and weight loss are common Diagnosis Initial evaluation includes a clinical history and physical examination, ECG, echocardiography, chest radiography, lab [pathologyoutlines.com]
481 Fears Phobias and AnxietiesCats 488 Feline Foamy Virus Infection FFV 494 Feline Immunodeficiency Virus Infection FIV 500 Feline Leukemia Virus Infection FeLV 506 Fever 512 Fibrosarcoma Bone 517 Fibrosarcoma Gingiva 518 Food Reactions Dermatologic [books.google.es]
Patients often present with dyspnea, chest pain, palpitations, fever, or weight loss. [ncbi.nlm.nih.gov]
Often times the symptoms of pericardial disease such as fever, chest pain, and shortness of breath are non-specific, making an accurate diagnosis a challenging task. [books.google.com]
Signs Fever (if infectious) Fever >101.3 F (38.5 C) may suggest more significant infection (e.g. [fpnotebook.com]
- Constitutional Symptom
Signs and symptoms of embolization include myocardial infarction, stroke, peripheral malperfusion, and mesenteric ischemia. Constitutional symptoms such as malaise, weight loss, myalgias, and fevers can occur due to elaboration of cytokines. [accesssurgery.mhmedical.com]
Clinical manifestations of myxomas consist in a triad: constitutional symptoms, embolization and intracardiac obstruction. [wikiecho.org]
Segin JR, Beigbeder JY, Hvass U et al: Interleukin-6 production by cardiac myxomas may explain constitutional symptoms. J Thorac Cardiovasc Surg 1992;103:599 26. [fac.org.ar]
A classic clinical triad of obstructive cardiac symptoms, embolic phenomena, and constitutional symptoms has been described, and most patients have at least one of these signs at presentation (, 21,, 22,, 25 ). [pubs.rsna.org]
- Swelling
Treatment involving chemotherapy and radiation can have serious side effects, such as: changes in appetite bleeding problems anemia constipation diarrhea fatigue hair loss infection nausea/vomiting pain swelling Radiation may also cause changes in the [healthline.com]
The following symptoms may be seen: Tiredness Shortness of breath Chest pain or discomfort, such as feelings of heaviness/fullness of the chest Fainting, or feeling faint or dizziness Swelling in the lower legs Rarely, these tumors, especially if large [dovemed.com]
Abdominal swelling and ascites. In: Longo DL, Fauci AS, Kasper DL, Hauster SL, Jameson JL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 18th ed. Vol. 1. New York: Mc Graw Hill, 2012. p. 330-3. [ Links ] 9. Gordon FD. Ascites. [scielo.isciii.es]
Cardiovascular
- Pulsus Paradoxus
Pulsus paradoxus: In this condition, inspiratory drop in systolic blood pressure is more than 10mmHg. Pulsus paradoxus and cardiac tamponade. In cardiac tamponade, cardiac chambers are compressed or strangulated. [drnajeeblectures.com]
Cardiac tamponade is diagnosed on the basis of clinical (engorged jugular veins, pulsus paradoxus) and echocardiographic (right atrial wall collapse, dilated vena cava) findings. [moh-it.pure.elsevier.com]
Pulsus paradoxus: exaggeration of the normal respiratory variation in systemic blood pressure (defined as a decrease in systolic blood pressure of more than 10 mm Hg with inspiration). [patient.info]
Pulsus paradoxus: definition and relation to the severity of cardiac tamponade. Am Heart J 1988; 115:391–398. Bilchick KC, Wise RA. Paradoxical physical findings described by Kussmaul: pulsus paradoxus and Kussmaul's sign. [clevelandclinicmeded.com]
A decrease in the systolic pressure of greater than 10 mmHg is called pulsus paradoxus, and it’s a classic sign of cardiac tamponade. [osmosis.org]
- Hypotension
This means that the cardiac chambers can’t fill with blood properly, causing a decrease in cardiac output or a lower amount of blood being squeezed out with each heartbeat, which leads to hypotension. [osmosis.org]
Symptoms that led referring physicians to order the echocardiographic study included dyspnea in 44 patients (83%), pleuritic chest pain in 22 (42%), cough in 5 (9%) and hypotension in 2 patients. [wjgnet.com]
Signs Classic triad of pericardial tamponade: hypotension, muffled heart sounds, jugular venous distention. [patient.info]
Difficulty breathing (dyspnea) Chest pain Night sweats Irregular heartbeat (arrhythmia) Pericardial effusion Cardiac tamponade (compression of the heart) Constrictive pericarditis (inflammation of the pericardium) Less Common Symptoms Heart murmurs Hypotension [mesothelioma.com]
- Pericardial Friction Rub
Definition / general Pericarditis is an inflammation of the pericardium characterized by chest pain, pericardial friction rub and serial ECG changes Terminology Idiopathic pericarditis Acute pericarditis Chronic pericarditis Chronic effusive pericarditis [pathologyoutlines.com]
Auscultation may reveal pericardial friction rub, and heart sounds may be faint. [textbookofcardiology.org]
Signs A pericardial friction rub is present on auscultation in 60-85% of cases. Clinically, the presence of a pericardial friction rub is pathognomonic - often a rub can be heard even when a pericardial effusion is present. [patient.info]
MEDICAL TREATMENT Patients with acute inflammatory signs (fever, chest pain, pericardial friction rub) should receive aspirin or non-steroid anti-inflammatory drugs. [wjgnet.com]
Skin
- Petechiae
The initial manifestations of atrial myxoma may also resemble those of infective endocarditis and include fever, chills, lethargy, arthralgias, petechiae, and positive blood cultures, although infection of an atrial myxoma is rare (, 21,, 26 ). [pubs.rsna.org]
Neurologic
- Confusion
She stated that her ability to ambulate had been declining since her weight loss, and her son also had noted increased confusion in the days preceding her presentation. Diagnostic tests. [consultant360.com]
Anxiety and confusion. Hiccoughs. Signs Classic triad of pericardial tamponade: hypotension, muffled heart sounds, jugular venous distention. [patient.info]
[…] especially if large, may cause hypoglycemia Hypoglycemia results in Doege-Potter syndrome, which occurs due to secretion of insulin-like growth factor-2 (IGF-2) by the tumor cells (paraneoplastic syndrome) The signs and symptoms of hypoglycemia include confusion [dovemed.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]
The location and degree of invasiveness of these lesions makes them less likely to be confused clinically with myxomas. [pubs.rsna.org]
- Irritability
Tumor growth in the pericardium causes irritation of the mesothelial lining. During the procedure, a surgeon removes the irritated lining of the heart. This eases the constriction caused by inflammation. [mesotheliomagroup.com]
The high levels of urea in the blood irritate the serous pericardium. More rarely, cardiac tamponade can happen due to hypothyroidism or because of chronic inflammation from a connective tissue disease. [osmosis.org]
Definition (NCI_CTCAE) A disorder characterized by irritation to the layers of the pericardium (the protective sac around the heart). Definition (NCI) An inflammatory process affecting the pericardium. [fpnotebook.com]
Effusion is thought to result from mechanical irritation by friction or blood vessel rupture. The relationship between this patient’s tumor and the documented pericardial inflammation is not clear. [ctsnet.org]
Phrenic nerve irritation can cause hiccups. With a small effusion, the physical examination is unremarkable. [clevelandclinicmeded.com]
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]
Although the diagnostic workup often starts with chest roentgenography or transthoracic echocardiography, further investigation is often warranted in order to visualize the entire pericardium and more specifically characterize the lesions in question. [acc.org]
Pericardial effusion workup. Medscape Reference. Available online at http://emedicine.medscape.com/article/157325-overview. Accessed 9/8/2016. Chen, M. (Updated 2016 January 24). Pericarditis. MedlinePlus Medical Encyclopedia. [labtestsonline.org]
The objective of this article is to review the etiology, workup, and treatment for this disease, especially new, emerging therapeutic options. [dovepress.com]
X-Ray
- Pericardial Effusion
Pericardial Effusion How do you distinguish cardiomegaly from pericardial effusion? There is pulmonary congestion in CHF and pulmonary oligemia in pericardial effusion. Shape of the heart is helpful Water bottle appearance in pericardial effusion. [stritch.luc.edu]
Cytopathology of pericardial effusions. Acta Cytol. 1980 Sep-Oct; 24 (5):401–412. [ PubMed ] [ Google Scholar ] Zipf RE, Jr, Johnston WW. The role of cytology in the evaluation of pericardial effusions. [ncbi.nlm.nih.gov]
Abstract Echocardiograms of three patients with metastatic carcinoma or lymphoma showed a sonolucent space posterior to the left ventricular epicardium, as seen in pericardial effusion. However, at surgery or autopsy no pericardial fluid was found. [annals.org]
Table 1 Causes of pericardial effusion. [wjgnet.com]
pericardial effusion in HIV patients. [patient.info]
- X-Ray Abnormal
[…] ordered when someone has some combination of the following signs and symptoms : Chest pain, sharp or sometimes dull, that may be relieved by bending forward Coughing Difficulty breathing Fever Fatigue Changes in heart rhythm Enlarged heart size on chest X-ray [labtestsonline.org]
- Chest X-Ray Abnormal
[…] on chest X-ray Abnormal pericardial appearance on echocardiogram Test results can help distinguish between types of pericardial fluid and help diagnose the cause of fluid accumulation. [labtestsonline.org]
Treatment
Talk to someone who can help you explore potential treatment options. Treatments Treatment for pericardial mesothelioma has not been fully developed due to the rarity of the disease. [mesotheliomagroup.com]
The final section includes a range of topics such as the pericardium, cardiovascular effects of endocrine treatments, primary cardiac tumors and malignancies of the myocardium and pericardium. [books.google.com]
Treatment Treatment options for pericardial mesothelioma are limited due to the proximity of the tumors to the heart. [mesotheliomaguide.com]
[…] discontinuation of treatment. [dovepress.com]
Prognosis
What’s the prognosis for this disease? Most pericardial mesothelioma patients have a prognosis of 6 months. Yet, there are always exceptions to the rule. Talk to someone who can help you explore potential treatment options. [mesotheliomagroup.com]
Outcomes and prognosis The prognosis of resectable benign tumors is usually very good with low recurrence rates depending on the type of tumor. [accesssurgery.mhmedical.com]
Prognosis is poor even after surgical resection (varies from 10 months to 5 years.) Local recurrence is common and show tendency for local invasion. [histopathology-india.net]
prognosis compared with those with poor health Age of the individual: Older individuals generally have poorer prognosis than younger individuals Whether the tumor is occurring for the first time, or is a recurrent tumor. [dovemed.com]
What is the Prognosis for Pericardial Mesothelioma? Though all mesothelioma patients face a poor prognosis, pericardial mesothelioma has the worst life expectancy. [mesothelioma.com]
Etiology
In these patients, cardiac tamponade recurred in 35 patients, of which only 2 (5.7%) had an idiopathic etiology. [revespcardiol.org]
[…] disease are prominent etiologies of pericardial effusion. [wjgnet.com]
Etiology of large pericardial effusions. Am J Med 1993;95:209-13. Levy PY, Corey R, Berger P, et al. Etiologic diagnosis of 204 pericardial effusions. Medicine (Baltimore) 2003;82:385-91. [acc.org]
The patient was admitted for investigation of the organized pericardial effusion which appeared to be evolving to constrictive pericarditis of unknown etiology. [revportcardiol.org]
Epidemiology
This timely volume covers history, epidemiology, demographics, clinical diagnosis, pathology, imaging by echo, CT and MRI of both benign and malignant cardiac tumors, either primary or secondary. [books.google.com]
Chemotherapy Heart tumors Neoplastic pericarditis Pericardial effusion Cardiology and Cardiovascular Medicine Radiology Nuclear Medicine and imaging Cite this Apa Standard Harvard Vancouver BIBTEX RIS @article{62fb3a6558f9433cbfc99628911f6c49, title = "Epidemiology [moh-it.pure.elsevier.com]
Epidemiology Although neoplastic involvement of the heart is commonly regarded as a rare condition, a compilation of autopsy series suggests that 3.4% (642/19130) of general autopsies 13-18 and 11.6% (1280/11078) of cancer autopsies 13-21 demonstrate [jamanetwork.com]
Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis. Annals of Epidemiology, 27(5):348-359. doi: 10.1016/j.annepidem.2017.04.001 Nambiar, C. et al. (1992). Primary pericardial mesothelioma: One-year event-free survival. [asbestos.com]
Epidemiology Primary cardiac tumors are rare with an overall incidence of 0.02 percent. Malignant tumors metastatic to the heart are much more common with an incidence of 1.23 percent. [accesssurgery.mhmedical.com]
Pathophysiology
Pathogenesis Pathophysiology Chemodectoma → pericardial effusion → cardiac tamponade → right-sided cardiac failure. Timecourse Very slow growing. May be incidental finding at post-mortem. [vetstream.com]
Pathophysiology Cardiac tumors arise from various cells in the heart. Clinical effects of these tumors are based chiefly on the size and location of the mass. [accesssurgery.mhmedical.com]
[…] pericardium characterized by chest pain, pericardial friction rub and serial ECG changes Terminology Idiopathic pericarditis Acute pericarditis Chronic pericarditis Chronic effusive pericarditis and chronic constrictive pericarditis Recurrent pericarditis Pathophysiology [pathologyoutlines.com]
Pathophysiology: concepts of altered health states (7th ed.). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-0-7817-4988-6. ^ a b c d Gwinnutt CL, Driscoll PA (2003). Trauma Resuscitation: The Team Approach (2nd ed.). Oxford: BIOS. [en.wikipedia.org]
(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]
Prevention
Medical therapy for specific conditions (e.g., tuberculous pericarditis) is recommended to prevent the progression of constriction. Multimodality imaging. [acc.org]
Tumors in the pericardium may squeeze (constrict) the heart, preventing it from filling properly. Chest pain and heart failure may develop. [merckmanuals.com]
Pericardial thickening and effusions prevent the heart from expanded and contracting normally. [mesotheliomagroup.com]
The pericardium is the outer layer of the heart The cause of formation of the tumor is unknown and currently, no known methods exist to prevent occurrence of the tumor Most small tumors are asymptomatic, though the larger ones may compress the surrounding [dovemed.com]