Presentation
We present a rare case of tension pneumopericardium with cardiogenic shock due to bronchopericardial fistula in a patient with bronchogenic carcinoma who was successfully treated with transpericardial intervention. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Unexplained chest pain following PPM insertion might be the only clue for such complication, although it might not always be present. [ncbi.nlm.nih.gov]
A 47-year-old homeless man presented to the emergency department 1 week after the onset of chest pain. He was hemodynamically stable. The physical examination was unremarkable. [doi.org]
- Asymptomatic
Pneumopericardium ranges from an asymptomatic to life-threatening condition, e.g., in cases of cardiac tamponade. The underlying etiology should be sought so that treatment can be expedited. [ncbi.nlm.nih.gov]
The patient has remained asymptomatic, apart from tachycardia of 160 beats/minute initially for the first few hours. The pneumopericardium resolved on its own. [eurorad.org]
Most of the times, PR is asymptomatic and constitutes a radiological curiosity. The intra-spinal air reabsorbs spontaneously and completely into the circulation. [thoracicmedicine.org]
The condition may remain asymptomatic or may progress to life-threatening conditions like tension pneumopericardium or cardiac tamponade. [en.wikipedia.org]
- Falling
A 76-year-old man was transferred to our institution with blunt chest trauma after falling off a roof. Chest computed tomography (CT) revealed left pneumothorax and pneumopericardium but no displacement of the heart into the hemithorax. [ncbi.nlm.nih.gov]
In the absence of a fall in blood pressure, a conservative approach is probably indicated. [pediatrics.aappublications.org]
znanstveni Ključne riječi Pneumoperikard; Tenzioni pneumoperikard; Tupa ozljeda; Pneumomediastinum (Pneumopericardium; Tension pneumopericardium; Blunt trauma; Pneumomediastinum) Sažetak A 49-year-old man was admitted to the emergency room after a fall [beta.bib.irb.hr]
The injury can come from: A car accident A fall from heights A gunshot Stabbing Severe asthma Ventilators, especially in newborn babies Air pressure problems from scuba diving or an airplane that injures your ear, lung, or heart Other pneumopericardium [webmd.com]
People who work in high locations and are at risk of falls also face greater odds of developing pneumopericardium. Babies born prematurely are also more likely than full-term babies to have pneumopericardium. [healthline.com]
- Collapse
'Simple' pneumopericardium produces no discernible circulatory compromise; however, simple pneumopericardium may progress rapidly to produce cardiovascular compromise or circulatory collapse, when it is termed 'tension' pneumopericardium. [ncbi.nlm.nih.gov]
Journal of cardiovascular ultrasound 2016 A case of 46-year-old man, with end-stage renal disease on chronic hemodialysis and who developed a large circumferential pericardial effusion of 40 mm in diastole with swinging heart and diastolic right atrium collapse [semanticscholar.org]
The follow-up echocardiography showed the absence of RV wall diastolic collapse. A water-sealed chest tube bottle was connected at the end of the catheter for further drainage. [jkms.org]
• Tension pneumopericardium is one of the life threatening injuries and should be kept in the differential diagnosis in any trauma patient presenting with circulatory collapse with no obvious cause. • Tension pneumopericardium is a reversible cause [file.scirp.org]
- Fatigue
Case Presentation A 30 year old male presented with gross haematuria, bleeding from gums, fatigue, arthralgia, myalgia and fever for two weeks. At presentation his WBC count was 28.6x10 9 /l, Haemoglobin 8.5 g/dl and platelets 3x10 9 /l. [austinpublishinggroup.com]
A 43-year-old man admitted for vomiting, back pain, and general fatigue was found in laboratory findings on admission to have plasma glucose of 657 mg/d l, HbA 1c of 7.7%, arterial gas indicating metabolic acidosis, and a high urine ketone body count. [ci.nii.ac.jp]
Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and [scienceopen.com]
【飛蚊症】*myodesopsia (百) 【百日咳】*whooping cough *pertussis 【標的赤血球増加症】*leptocytosis 【表皮炎】*epidermitis 【表皮下膿瘍】*subepidermal abscess 【表皮水疱症】*bullous epidermolysis *epidermolysis bullosa[L] (略 EB) 【表皮剥離】*epidermolysis 【疲労】*fatigue 【疲労骨折】*fatigue fracture *stress [medo.jp]
Respiratoric
- Respiratory Distress
Neonatal pneumopericardium is usually a complication of mechanical ventilation in premature infants with respiratory distress syndrome. [ncbi.nlm.nih.gov]
Keywords Respiratory Distress Syndrome Pneumothorax Heart Sound Tube Placement Acute Episode These keywords were added by machine and not by the authors. [link.springer.com]
- Dyspnea
Several hours after the procedure, the woman complained of severe retrosternal pain and mild dyspnea. [ncbi.nlm.nih.gov]
Soberman Medicine The American journal of the medical sciences 2008 A healthy 32-year-old woman presents with a 1-month history of febrile illness, malaise, and weakness; more recently, she also had resting dyspnea, which was progressively worsening, [semanticscholar.org]
A 70-year-old woman with a 5-month history of metastatic pancreatic cancer was admitted to the hospital with dyspnea, swelling edema of the legs, and fever. Shortly thereafter she developed an intermittent atrial fibrillation. [ahajournals.org]
Gastrointestinal
- Vomiting
We report a case of pneumopericardium in a 25-year-old woman following a recent episode of forceful vomiting possibly acting as trigger factor. The diagnosis was made by posteroanterior chest radiography and confirmed with computed tomography. [ncbi.nlm.nih.gov]
A 43-year-old man admitted for vomiting, back pain, and general fatigue was found in laboratory findings on admission to have plasma glucose of 657 mg/d l, HbA 1c of 7.7%, arterial gas indicating metabolic acidosis, and a high urine ketone body count. [ci.nii.ac.jp]
[…] no identified predisposing condition, such as asthma, interstitial disease or graft-versus-host disease. 1,6 The precipitating factors that are associated with spontaneous PM are those that produce a sudden increase in intrathoracic pressure, mainly vomit [archbronconeumol.org]
[…] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting [scienceopen.com]
/*vomition/*vomitus *emesis (カ) 【カタル性胃炎】*catarrhal gastritis 【カタル性炎】*catarrhal inflammation 【カタル性舌炎】*catarrhal glossitis *glossitis catarrhalis[L] 【カフェオーレ斑】*cafe-au-lait spot 【カポジ肉腫】*Kaposi's sarcoma 【カリウム血症】*kalemia 【カリウム欠乏症】*kaliopenia 【カリニ肺炎】*pneumocystis [medo.jp]
- Abdominal Pain
A 50-year-old woman presented with chronic epigastric abdominal pain and constipation. She underwent diagnostic upper and lower endoscopy for further evaluation. [ncbi.nlm.nih.gov]
pain *abdominalgia 【腹部外傷】*abdominal trauma 【腹部狭心症】*abdominal angina 【腹部出血】*abdominal hemorrhage *abdominal bleeding 【腹部腫瘍】*abdominal tumor 【腹部疝痛】*celialgia 【腹部大動脈瘤】*abdominal aortic aneurysm 【腹部癲癇】*abdominal epilepsy 【腹部ヘルニア】*laparocele (=腹壁瘤) 【腹部膨大】 [medo.jp]
Liver, Gall & Pancreas
- Hepatomegaly
The findings of physical examination included cardiac auscultation of a characteristic «bubbling water» systodiastolic murmur and hepatomegaly of 2 cm. The ECG revealed diffuse negative T waves. [revespcardiol.org]
During the course of the next few days, the patient developed aplastic anaemia, protein-losing enteropathy, pneumonia, hepatomegaly and bilateral pleural effusions. [eurorad.org]
[…] reflux 【肝硬変症】*liver cirrhosis/*hepatic cirrhosis/*cirrhosis *hepatocirrhosis 【肝細胞癌】*hepatocellular carcinoma (=肝癌) 【肝細胞性黄疸】*hepatocellular jaundice 【肝出血】*liver bleeding/*hepatic bleeding *liver hemorrhage/*hepatic hemorrhage *hepatorrhagia 【肝腫大】【肝肥大】*hepatomegaly [medo.jp]
Cardiovascular
- Chest Pain
A 47-year-old homeless man presented to the emergency department 1 week after the onset of chest pain. He was hemodynamically stable. The physical examination was unremarkable. [doi.org]
We are presenting a case of a patient who presented 5 days after PPM insertion with new-onset pleuritic chest pain. She had a normal chest X-ray (CXR), and acceptable pacing checks. [ncbi.nlm.nih.gov]
- Hypotension
There have been some prior case reports of pneumopericardium that occurred during positive pressure ventilation; in this patient hypotension due to tension pneumopericardium occurred after extubation. [ncbi.nlm.nih.gov]
[…] pneumopericardium is much less common than pneumomediastinum, the former usually not occurring in adults unless there is a direct injury to the pericardium Clinical Findings Depend on the amount of air and how rapidly it accumulates Substernal chest pain Hypotension [learningradiology.com]
After a week of high positive-pressure ventilation in the intensive care unit, he experienced hypotension, severe hypoxemia and sudden onset of subcutaneous emphysema in the right chest wall. [cmaj.ca]
[citation needed] Diagnosis[edit] On physical examination, the patient may have the classic “Beck’s triad” – hypotension, raised JVP and distant heart sounds, when complicated by cardiac tamponade. [en.wikipedia.org]
- Pericardial Friction Rub
In addition to ECG changes, other findings include dyspnoea, pericardial friction rub, pulmonary rales and an elevated central venous pressure. [jmedicalcasereports.com]
- Heart Disease
Respiratory disease Heart disease Pleural disease Pericardial disease Diseases of the osteoarticular system Keyword (es) Anestesia Diagnóstico Drenaje Derrame Hombre Neumopericardio Neumotórax Ventilación espontánea Aparato circulatorio patología Aparato [pascal-francis.inist.fr]
Spodick, “Pericardial Diseases,” In: Braunwald Zipes Libby’s Heart Disease—A Textbook of Cardiovascular Medicine, 6th Editon, HIE Saunders, Philadelphia, 2001, p. 1832. [file.scirp.org]
*fatty infiltration of heart *steatosis cordis[L] 【心身障害】*psychosomatic disorder 【心臓炎】*carditis ^=心筋炎 【心臓下垂症】*cardioptosis 【心臓恐怖症】*cardiophobia 【心臓疾患】【心臓病】【心疾患】*heart disease *cardiac disease *cardiopathy 【心臓心膜炎】*cardiopericarditis 【心臓性肝硬変】【心性肝硬変】*cardiac [medo.jp]
- Retrosternal Chest Pain
While involved in a rugby match, an 11-year-old boy received a chest compression by 3 players during a tackle. He continued to play, but 2 hours later, he developed sharp retrosternal chest pain. [ncbi.nlm.nih.gov]
Skin
Psychiatrical
- Suggestibility
We performed serial echocardiography for any evidence of diastolic dysfunction that would have suggested progression to tension pneumopericardium. [ncbi.nlm.nih.gov]
Neurologic
Urogenital
- Uremia
Tension pneumopericardium leads to cardiac tamponade during hand-assisted ventilation in patients with uremia. J Thorac Cardiovasc Surg 2008;135:432-3. 2.↵ Lasocki S, Castier Y, Geffroy A, et al. [cmaj.ca]
[…] blood in urine 【尿道炎】*urethritis 【尿道拡張】*urethral dilation 【尿道カルンクル】*urethral caruncle 【尿道結石】*urethral calculus 【尿道損傷】*urethral injury 【尿道断裂】【尿道破裂】*urethral rupture 【尿道脱】*urethral prolapse 【尿道痛】*urethralgia *urethrodynia 【尿道閉塞】*urethral obstruction 【尿毒症】*uremia [medo.jp]
Treatment
Treatment options are limited. We present a rare case of tension pneumopericardium with cardiogenic shock due to bronchopericardial fistula in a patient with bronchogenic carcinoma who was successfully treated with transpericardial intervention. [ncbi.nlm.nih.gov]
Cardiac tamponade needs immediate treatment, though. The most common treatment for this complication is pericardiocentesis. This is where your doctor inserts a long, narrow tube called a catheter into your pericardial sac and draws out the air. [webmd.com]
You will probably see some improvements in your symptoms soon after treatment. Pneumopericardium caused by a sudden trauma has a faster recovery time if you received prompt treatment. [healthline.com]
The patient did not present clinical manifestations of cardiac tamponade, so conservative treatment was decided on. [revespcardiol.org]
Prognosis
T/NK cell lymphomas show aggressive and invasive clinical progression, with a poor prognosis. Without treatment, survival is measured in months. [ncbi.nlm.nih.gov]
Thirty-three per cent of the fatalities were related to PPC; however, the long-term prognosis is probably more closely related to the severity of underlying lung disease or other complications than to PPC. Article History Published in print: 1982 [pubs.rsna.org]
The appearance is similar to pneumomediastinum, but may be differentiated by the following features; heart remains obscured throughout the cardiac cycle involves the subxiphoid window characteristically spared in pneumomediastinum 4 Treatment and prognosis [radiopaedia.org]
[…] absence of tension then, in general, treatment is aimed at the specific cause if signs of tamponade develop then urgent pericardiocentesis is required a pericardial catheter should be left in place in order to prevent the development of further tension Prognosis [gpnotebook.co.uk]
Without prompt evacuation of the pericardial air, prognosis is poor. [journals.lww.com]
Etiology
The underlying etiology should be sought so that treatment can be expedited. Pneumopericardium may result from traumatic and nontraumatic etiologies. [ncbi.nlm.nih.gov]
Of these 21 patients with simultaneous pneumomediastinum, eight patients had associated pneumopericardium; five patients with pneumopericardium had blunt chest trauma as etiology and three patients had penetrating trauma as etiology for pneumopericardium [ijsronline.net]
Etiology Underlying causes include: positive pressure ventilation thoracic surgery/pericardial fluid drainage penetrating trauma blunt trauma (rare) infectious pericarditis with gas-producing organisms fistula between the pericardium and an adjacent air-containing [radiopaedia.org]
Chapter: Chest Subchapter: Mediastinum, Heart & Vessels ( Read entire chapter ) Diagnosis: Pneumomediastinum / Pneumopericardium - introduction Pneumomediastinum/Pneumopericardium Etiology is multifactorial: · Blunt force or penetrating chest trauma · [radiologytutorials.com]
Epidemiology
We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. [scienceopen.com]
Pèntek Z, Bakó B, Szentgáli G, Tabár L, Balogh J, Szarka J: Mammographic screening for breast cancer in a rural population preselected via physical examination and epidemiologic questionnaire. Röntgenblätter, 1978;31:173. [mammographyed.com]
Pathophysiology
Its radiographic appearance on anteroposterior films of the supine infant may be confused with pneumomediastinum or pneumothorax so that knowledge of the relevant fascial layers is necessary for an understanding of the pathophysiology and allows proper [pediatrics.aappublications.org]
[citation needed] Pathophysiology[edit] The mechanism responsible for pneumopericardium is the ‘Macklin effect’ – There is initially an increased pressure gradient between the alveoli and the interstitial space. [en.wikipedia.org]
The pathophysiology was demonstrated by Macklin in animal studies 4 ). [kjim.org]
Prevention
In most cases the air will resorb without active management but if a tension pneumopericardium develops urgent drainage is required to prevent cardiovascular compromise and death. [degruyter.com]
Cardiac tamponade was prevented by timely aspiration of the pericardial effusion. [austinpublishinggroup.com]
Management: Seek expert advice. in the absence of tension then, in general, treatment is aimed at the specific cause if signs of tamponade develop then urgent pericardiocentesis is required a pericardial catheter should be left in place in order to prevent [gpnotebook.co.uk]
Fracture of tracheostomy tubes-pathogenesis and prevention. J Laryngol Otol 1983;97:771-4. [ PUBMED ] 3. Kohli GS, Yadav SP, Sharma RC, Raj B, Chawla RK. Tracheostomy tubes-presenting as foreign bodies in the tracheobronchial tree. [laryngologyandvoice.org]