Presentation
The aim of this study was to document the mode of presentation and to suggest a protocol for management. [ncbi.nlm.nih.gov]
Cardiovascular
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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]
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Retrosternal Chest Pain
He continued to play, but 2 hours later, he developed sharp retrosternal chest pain. A chest radiograph and an echocardiograph at the nearest emergency department showed pneumopericardium and pneumomediastinum. [ncbi.nlm.nih.gov]
Psychiatrical
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Suggestibility
Bright spots were seen rapidly moving along the pericardial layer during diastole with comet-tail artifacts extending across the whole image of the heart and disappearing during systole, suggesting pneumopericardium. [ncbi.nlm.nih.gov]
Suggestions for corrective surgery have also not been taken seriously and the patient as of now is lost to follow-up. [laryngologyandvoice.org]
Workup
X-Ray
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Pneumothorax on Chest X-Ray
Twenty days after the procedure, the patient complained of shortness of breath and was found to have a 30 % apical left pneumothorax on chest X-ray as a not unusual complication of the subclavian venous access. [ncbi.nlm.nih.gov]
Eight hours after the procedure, the patient complained of shortness of breath and was found to have a 30% right pneumothorax on chest X-ray. Immediately, a chest tube was inserted, promptly relieving the symptoms. [academic.oup.com]
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Normal Chest X-Ray
She had a normal chest X-ray (CXR), and acceptable pacing checks. However, a CT scan of the chest showed pneumopericardium and pneumothorax secondary to atrial lead perforation. The pain only settled by replacing the atrial lead. [ncbi.nlm.nih.gov]
Rhythm
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Premature Atrial Contractions
These findings may be non-specific ST-segment or T-wave changes, axis deviation and dysrhythmias, such as premature atrial contractions, bundle branch blocks and ventricular fibrillation [ 1 ]. [jmedicalcasereports.com]
T Wave
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T Wave Inversion
inversion and low voltages. [jmedicalcasereports.com]
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]
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]
Treatment and prognosis Complications cardiac tamponade A pneumopericardium can usually be distinguished from pneumomediastinum, since gas in the pericardial sac should not rise above the anatomic limits of the pericardial reflection on the proximal great [radiopaedia.org]
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]
[…] 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]
It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical, anesthesiological and diagnostic interventions; malignancy and its associated therapy. [thoracicmedicine.org]
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]
The pathophysiology was demonstrated by Macklin in animal studies 4 ). [kjim.org]
A rise in the intra-alveolar pressure above atmospheric pressure is important in the pathophysiology of pneumopericardium and pneumomediastinum. [ijsronline.net]
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]
References Jeng MJ, Lee YS, Tsao PC, Soong WJ (2012) Neonatal air leak syndrome and the role of high-frequency ventilation in its prevention. J Chin Med Assoc 75: 551-559. [omicsonline.org]