Presentation
Two cases of cardiac tamponade complicating leukaemia are presented. [ncbi.nlm.nih.gov]
Entire Body System
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Hypoxemia
Significant hypoxemia can result from right-to-left intracardiac shunting through a patent foramen ovale, an atrial septal defect or a ventricular septal defect. [ncbi.nlm.nih.gov]
With decreased oxygen, a gas vital to life, the body cannot function properly and one can suffer from serious hypoxemia (oxygen deficiency) and worst - death. [docdoc.com]
Respiratoric
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Aspiration
The mean aspirated volume was 1,078 mL, with a mean autotransfused volume of 390 mL. [ncbi.nlm.nih.gov]
(ACC) Definition (NCI_CDISC) The aspiration of excess fluid between the pericardium and the heart. Definition (MSH) Surgical puncture of the pericardial cavity for the aspiration of fluid. [fpnotebook.com]
If the patient is in extremis, aspirate as much fluid as possible at this point. Removal of 30-50 mL of fluid can result in clinical improvement. Once aspiration is finished, untwist the syringe from the needle. [jove.com]
Gastrointestinal
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Regurgitation
A transthoracic echocardiogram performed 24 h later showed improved motion of the RV and the tricuspid valve, resulting in a reduction in tricuspid regurgitation. [ncbi.nlm.nih.gov]
A 75-year-old man with coronary artery disease, atrial fibrillation, sick sinus syndrome with permanent pacemaker, hypertension, dyslipidemia, and previous exertional dyspnea related to moderately severe mitral regurgitation from myxomatous degeneration [ahajournals.org]
Post bypass TEE revealed mild tricuspid regurgitation with a RVSP of 36 mm Hg. [annals.in]
Cardiovascular
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Left Ventricular Dysfunction
The patient developed an early left ventricular dysfunction after removal of the pericardial effusion, with complete recovery within 10 days. [ncbi.nlm.nih.gov]
Transitory left ventricular dysfunction after pericardiocentesis is a rare complication and its exact incidence is unknown. [revespcardiol.org]
An unusual complication following pericardiocentesis: reversible left ventricular dysfunction. J Cardiovasc Med. 2015;16 Suppl 2:S133–5. View Article Google Scholar Sevimli S, Arslan S, Gundogdu F, Senocak H. [cardiovascularultrasound.biomedcentral.com]
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Refractory Shock
We conclude that high-volume hemofiltration can be helpful as an adjuvant treatment for refractory shock after pericardiocentesis for chronic cardiac tamponade. The mechanism of the observed hemodynamic improvement remains to be investigated. [ncbi.nlm.nih.gov]
Skin
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Ulcer
We describe a geriatric patient having a pneumopericardium from pericardial penetration by a gastric ulcer. [ncbi.nlm.nih.gov]
Psychiatrical
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Withdrawn
The catheter in the right ventricle was withdrawn via a second catheter placed in the pericardial cavity. Spontaneous blood control was established, and with no increase in pericardial effusion surgical intervention was not required. [ncbi.nlm.nih.gov]
Once the needle is inserted, a clamp is attached to hold it in place, and fluid is withdrawn through the needle into multiple specimen containers. The procedure takes 10 to 20 minutes. [healthcommunities.com]
On reaching the pericardial fluid, the steel core of the needle was immediately withdrawn, leaving only the polytef sheath in the pericardial space. [content.onlinejacc.org]
If no fluid is aspirated, the needle should be withdrawn promptly and redirected. In the absence of ultrasound guidance, withdraw the needle to the skin and redirect it along a deeper posterior trajectory. [forums.studentdoctor.net]
[…] may be sent in for analysis, if the procedure is performed for diagnostic purposes or just drained, if it is done to relieve pressure on the heart due to fluid accumulation After the needle is withdrawn, firm pressure is applied to minimize any bleeding [dovemed.com]
Workup
The aim of this study was to examine the etiology of pericardial effusions requiring a percutaneous intervention, either because of hemodynamic compromise or for a diagnostic workup, to determine how often fluid cytology is requested in unsuspected as [ahajournals.org]
Serum
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Dyslipidemia
A 75-year-old man with coronary artery disease, atrial fibrillation, sick sinus syndrome with permanent pacemaker, hypertension, dyslipidemia, and previous exertional dyspnea related to moderately severe mitral regurgitation from myxomatous degeneration [ahajournals.org]
Other Test Results
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Ejection Fraction Decreased
Left ventricular ejection fraction decreased to 20%, and there was akinesis in the left ventricular apex, and severe hypokinesis in the septum. The amount of daily drainage was decreased to 250 ml. [ncbi.nlm.nih.gov]
Treatment
High-volume hemofiltration was used as a rescue therapy after treatment with positive inotropic drugs proved ineffective. [ncbi.nlm.nih.gov]
Prognosis
CONCLUSIONS: The interval between cancer diagnosis and NCT onset, the impact of NCT on prognosis, and the prognosis after pericardiocentesis differed according to cancer type. [ncbi.nlm.nih.gov]
Prognosis following repeated drainages is less good. Guarded/poor prognosis for septic pericarditis and neoplasia. Further Reading Publications Refereed papers Recent references from PubMed and VetMedResource. [vetstream.com]
Etiology
Among etiologies, malignancy remains the most common cause of clinically significant pericardial effusion and is associated with a poor prognosis. [ncbi.nlm.nih.gov]
Epidemiology
Epidemiological data, procedure indications and etiology of the effusions were also recorded. [ncbi.nlm.nih.gov]
He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]
Epidemiology : Pericardial effusions : Small pericardial effusions are found in 3.4% of the general population during autopsy Increased prevalence in HIV patients from 5-43% Parasternal Long View – Normal 21% of lung, breast, leukemia patients have metastases [coreem.net]
Pathophysiology
Since transient ventricular dysfunction after pericardiocentesis is a very unusual complication, we present a review of the different mechanisms suggested in the literature to explain the pathophysiology of this rare phenomenon. [ncbi.nlm.nih.gov]
Epidemiology and pathophysiology of Takotsubo syndrome. Nat Rev Cardiol. 2015;12:387–9. View Article PubMed Google Scholar Yeh RW, Yu PB, Drachman DE. [cardiovascularultrasound.biomedcentral.com]
[…] metastases to the pericardium, resulting in effusions Tamponade : Incidence is 2/10,000 in the USA Causes: Malignancy Infection (bacterial or tubercular pericarditis) Idiopathic pericarditis Trauma Uremia Hypothyroidism (myxedema) Lupus Post-radiation Pathophysiology [coreem.net]
Prevention
Adjunctive imaging decreases procedural risk for difficult-to-access pericardial fluid collections and must be used to prevent inadvertent morbidities. [ncbi.nlm.nih.gov]
In this modern age when imaging guidance is more prevalent, complications from deep or inappropriate needle insertion may be prevented. [jove.com]