• Title/Summary/Keyword: Pericardial Effusion

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Early-Onset Postcardiac Injury Syndrome after Percutaneous Coronary Intervention Recovered with Steroids (경피적 관상동맥중재술 후 급성으로 발생한 스테로이드 치료로 회복한 심근 손상 후 증후군)

  • Kim, Min-Jeong;Yoon, Seong-Bo;Lee, Myong Dong;Kim, Si-Ho;Kim, Young Woo
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.565-570
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    • 2018
  • Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.

Surgical Experience of Pericardial Mesothelioma: 2 Cases (심막에 발생한 중피종의 수술적 치험 2예)

  • Bang, Jung-Hee;Woo, Jong-Soo;Choi, Pill-Jo;Park, Kwon-Jae;Jeong, Sang-Seok;Hong, Sook-Hee;Roh, Mee-Sook
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.437-440
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    • 2010
  • Cardiac mesotheliomas are rare. It is difficult to diagnose them at an early stage because the symptoms are nonspecific. Here we report two cases that had been initially diagnosed as constrictive pericarditis but later were definitively diagnosed, after pericardiectomy, as mesothelioma. The two patients complained of dyspnea that lasted 4 months and 10 years. Chest CT showed mild pericardial effusion and thickened pericardium, which was found enveloping the heart without any lumps. Median sternotomy showed that the overall pericardium was thickened by more than 10 mm. Pericardiectomy (phrenic nerve to phrenic nerve) was performed and post-operative histology confirmed malignant mesothelioma. In one patient the disease recurred near the pericardium post-operatively at 7 months and the patient died at 11 months. The other patient received chemotherapy and was still alive at post-operative month 16. Pericardial mesothelioma is an extremely rare disease exhibiting clinical signs similar to those of constrictive pericarditis, and should be diagnosed at an early stage of onset.

Successful Treatment of Left Atrial Auricular Abscess -A case report - (좌심방이-농양의 수술적 치료 -치험 1예 -)

  • 이정렬;김준성;배은정;노정일;안규리
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.272-274
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    • 2004
  • We report an unusual case of left atrial auricular abscess which was successfully treated by surgical resection, treatment with antibiotics and mediastinal irrigation. A 9-year-old female patient with previous history of urinary tract infection was admitted because of persistent fever. Echocardiography and magnetic resonance imaging revealed massive pericardial effusion and a mass lesion at the left upper cardiac border. Pericardiocentesis isolated Staphylococcus aureus on culture. The patient underwent mass removal under cardiopulmonary bypass. The mass was located within the left atrial auricular wall with fibropurulent abscess formation inside. Postoperative mediastinal irrigation was performed. Pathologic examination of the mass showed organized thrombi with chronic fibrosing mural endocarditis. She discharged on the 21st postoperative day without complication.

A Case Report of Improvement of Docetaxel-induced Fluid Retention in a Patient with Advanced Gastric Cancer using Herbal Decoction, Modified Bangkihwangki-tang

  • Choi, Seong-Heon;Lee, Jee Young;Lee, Sung-Un;Lee, Soo-Min;Park, Sora;Jung, Yee-Hong
    • The Journal of Korean Medicine
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    • v.35 no.4
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    • pp.110-115
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    • 2014
  • Objectives: A 54-year-old advanced gastric cancer patient developed severe fluid retention after docetaxel chemotherapy, at cumulative dose of $930mg/m^2$, with no improvement using diuretics or prophylactic glucocorticoids. Consequently, he changed chemotherapy regimen from docetaxel to paclitaxel. After he treated with herbal decoction Bangkihwangki-tang (BHT), which is widely used to treat several symptoms including edema in traditional Korean medicine, docetaxel-induced fluid retention (DIFR) was significantly improved along with associated symptoms, such as peripheral edema, pleural and pericardial effusion, pain, scleroderma, and hypoesthesia. As the symptoms were relieved, his performance status and ambulatory ability were improved. During herbal treatment, he continued chemotherapy without any problems and didn't show any adverse events related to herbal medicine. Although there is possibility of natural improvement progress after withdrawal of docetaxel, he showed shorter recovery period and significant improvement despite of severity of initial symptoms.

Severe Tricuspid Regurgitation Following Blunt Chest Trauma : Successful Repair by PTFE Chordal Replacement and Ring Annuloptasty (흉부외상후 발생한 삼첨판막 역류증에 있어서 새로운 건삭형성 및 판막링을 이용한 판막성형술 - 1례보고 -)

  • 원태희;원용순
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.533-536
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    • 1997
  • We report a successful repair of severe traumatic tricuspid regurgitation by PTFE chordal replacement and ring annuloplasty. A 64-year-old man with multiple trauma was referred to our department because of cardiomegaly on chest roentgenogram. Echocardiography showed moderate amount of pericardial effusion and severe tricuspid regurgitation with rupture of anterior papillary muscle. But he experienced progressive dyspnea, and chest roentgenogram showed pro ressive cardiomegaly. He underwent operation 4 months after trauma. The nterior papillary muscle was reinserted, and the valve was repaired by PTFE chordal replacements and ring annuloplasty. Postoperatively, the patient's functional status was improved, and there was trivial tricuspid regurgitation on echocardiographic examination.

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A Life-Threatening Bronchogenic Cyst

  • Han, Sung Joon;Cho, Hyun Jin;Kang, Min-Woong;Yu, Jae Hyeon;Na, Myung Hoon;Kang, Shin Kwang
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.69-71
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    • 2018
  • A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left atrium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.

Drainage with the Seldinger Technique for Cardiac Tamponade (심장압전에 대한 Seldinger 방법을 이용한 심낭배액술 -2례 보고-)

  • Kim, Jong-Won;Park, Seo-Wan;Kim, Byeong-Jun
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1152-1156
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    • 1996
  • Cardiac tamponade Is an acute, life-threatening emergency, requiring immediate decompression by a safe and simple method. The most effective method of drainage has been controversial. We experienced successful outcome for the treatment of cardiac tamponade with drainage using the Seldinger technique. The causes of the cardiac tamponade were hemopericardium after mitral and aortic valve replacement and malignant pericardial effusion due to primary lung cancer. They were treated with emergency rainage by the Seldinger technique without procedure-related complications. We believe that this technique is simple, safe for the treatment of cardiac tamponade.

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Benign Mediastinal Cystic Teratoma Complicated by Cardiac Tamponade due to Trauma (외상에 의하여 심장눌림증을 유발한 종격동 양성낭기형종)

  • Choe Ju-Won;Kim Yong-In
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.729-732
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    • 2006
  • Mediastinal teratoma is one of the most common lesions found in the anterior mediastinum, accounting for $8\sim13%$ of all mediastinal tumors. This tumor is incidentally detected by routine chest roentgengography, but pericardial perforation or pleural effusion occurs rarely. In our patient cardiac tamponade was developed due to anterior chest wall contusion, we confirmed the anterior mediastinal tumor. Vital signs were stabilized after the pericardiocentesis, and the patient underwent the tumor resection in the anterior mediastinum for a definite treatment. On histologic examination, the tumor revealed cystic structures composed of mature squamous epithelium, pilosebaceous glands, mature fat tissue, gastrointestinal mucosa, respiratory epithelium, and pancreatic tissues.

Removal of Bone Cement through Right Anterolateral Thoracotomy

  • Chung, Jin-Woo;Shin, Je-Kyoun;Chee, Hyun-Keun;Kim, Jun-Seok;Kim, Dong-Chan;Park, Jae-Bum
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.202-204
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    • 2012
  • A 55-year-old woman who had a history of percutaneous vertebroplasty was referred to our institution with sudden onset of chest pain. Computed tomography (CT) scan demonstrated a long, linear, highly-attenuated segment in the right side of the heart and fragmented pieces in the right pulmonary artery. The CT scan and echocardiogram revealed no pericardial effusion or hemopericardium. Based on these findings, we performed surgery through right anterolateral thoracotomy without cardiac arrest. As a result, we safely removed the foreign body. This approach may be a feasible and effective procedure for selected cases.

Pericarditis Arisen from Liver Abscess: Report of 2 Cases (간농양에 병발한 심낭염 치험 2례)

  • 서충헌
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.140-143
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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