• 한국임상수의학회지
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• 제40권4호
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• pp.308-313
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• 2023

A 1-year-old castrated male Korean Shorthair cat presented with dyspnea, anorexia, lethargy, and seizures. Physical examination revealed salivation, right forelimb hemiparesis, and rapid breathing. No abnormalities were detected on auscultation. Laboratory findings revealed increased levels of bilirubin, aspartate aminotransferase (AST), globulin, glucose, and a decreased albumin-to-globulin (A:G) ratio. Both N-terminal pro-B-type natriuretic peptide (NT-proBNP) and feline serum amyloid A (fSAA) levels were significantly elevated. Thoracic radiography revealed mild cardiomegaly and diffuse increased interstitial infiltration with soft tissue opacity in the periphery of the right caudal pleural space. Echocardiography and lung ultrasonography were performed to investigate the cause of mild cardiomegaly and soft tissue opacity in the pleural space. Echocardiography revealed a mild amount of echogenic pericardial effusion, and lung ultrasonography showed an echogenic soft tissue mass with no blood signal in the right caudal pleural space, suggestive of a granulomatous lesion. After obtaining 5 mL of pericardial fluid through pericardiocentesis, cytology of the pericardial effusion sample revealed marked neutrophils and macrophages with no bacteria. IDEXX feline infectious peritonitis (FIP) virus real-time reverse transcriptase polymerase chain reaction (RT-PCR) confirmed the presence of the FIP virus biotype in the sample. This case presents a rarely reported atypical mixed form of FIP in a cat diagnosed ante-mortem using pericardial effusion analysis. In this case, ultrasound examination played a crucial role in the definitive diagnosis of FIP by PCR biotyping through pericardiocentesis. Ultrasonography can be highly beneficial in guiding the diagnosis and evaluation of cats with suspected FIP.

• Journal of Chest Surgery
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• 제47권2호
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• pp.155-159
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• 2014

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.

• Journal of Chest Surgery
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• 제28권11호
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• pp.1001-1006
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• 1995

From January, 1990 to December, 1994, we have operated 10 patients with cardiac rupture. The patients are divided into two groups according to their clinical manifestation ; five patients in each hemorrhage and tamponade group. The patients in both groups could maintain their vital signs with closed thoracostomy and fluid resuscitation. The effect of pericardiocentesis was especially dramatic in three patients of tamponade group. The average time from injury to admission was 101 minutes and that of the patients who came our hospital via one or two other hospitals was 170 minutes comparing 31 minutes of those who came directly. The average time from admission to operation was 211 minutes. Considering 98 minutes for the diagnosis and preoperative management and another 30 minutes for the preparation for operation, operations were delayed by 83 minutes to get permission. We conclude that this delaying time for transport and operation of heart-ruptured patients should be shortened in order to manage them more effectively.

• 대한수의학회지
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• 제64권2호
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• pp.15.1-15.5
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• 2024

A 13-year-old, Maltese dog presented with syncope and lethargy. Abdominal ultrasonography demonstrated anechoic peritoneal effusion and hepatic congestion. A focal echogenic round mass compressing the right ventricle and atrium was observed on echocardiography. Cardiac tamponade and right ventricular outflow tract obstruction occurred. On computed tomography, a homogeneous soft-tissue structure compressing the right chamber without contrast enhancement, suspected to be loculated pericardial effusion. During pericardiocentesis, cardiac tamponade was resolved, and irregular pericardial thickening was noted. Pericardial effusion was exudate and gram-positive bacterial colonies were observed on cytology. A diagnosis of fibrinous pericarditis secondary to bacterial infection was established.

• Journal of Chest Surgery
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• 제17권2호
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• pp.257-262
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• 1984

Acute purulent pericarditis, though not common in incidence after introduction of antibiotics, is still potentially life treating isease. Since 1971, we have experienced 14 cases of acute purulent pericarditis with successful treatment. Among these 14 cases, 9 cases were male and they had high occurrence on their third to fifth decades in age distribution. Isolation of causative organisms were obtained in 11 cases through the bacterial culture of infectious source which was mainly pericardial effusion or blood, and the most frequently recovered organism was the staphylococcus aureus. Pre-existing inflammatory disease preceding to pericarditis, named as antecedent disease, were proved in 12 cases, and among which contiguous extension from the intrathoracic infection such as pneumonia or empyema accounted for the majority of antecedent disease. Pericardiocentesis with administration of antibiotics were tried in all cases, but result in recovery in 1 patient only. Remaining 13 cases had persistent picture of pericarditis and necessitated surgical drainage procedure. Ten of these 13 cases were underwent the open pericardial window using a mode of anterior approach in 4 and subxiphoid approach in 6 cases respectively. Two cases of subxiphoid group were reoperated by the anterior interphrenic pericardiectomy, due to insufficient drain of too thick effusion. In remaining 3 cases, anterior interphrenic pericardiectomy was performed initially because of purulent effusion already changed into fibrinopurulent peel with thickened pericardium. Through the experience of this series, we recommended that pericardiectomy should not be reluctant in purulent pericarditis as a initial surgical procedure for advantage of complete removal of infected space and avoidance of late constrictive pericarditis.

• Clinical and Experimental Pediatrics
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• 제49권6호
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• pp.686-690
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• 2006

심장압전을 동반하는 흉막 및 심낭삼출은 신생아, 특히 극소 저출생체중아에서 흔히 시행되는 제대정맥도관의 드물게 발생하는 치명적인 합병증으로서 신속한 진단과 치료를 요한다. 저자들은 극소저출생체중아에서 제대정맥도관의 합병증으로 발생한 흉막삼출과 심장압전을 동반한 심낭삼출을 흉관삽입과 심낭도관술로 치유한 1례를 경험하고, 아직 국내에는 보고된 적이 없어 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제34권6호
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• pp.437-440
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• 2017

A five-month-old, male Domestic Korean shorthair was referred to our hospital with a history of lethargy, anorexia, and globoid cardiac silhouette on thoracic radiography. Physical examination showed dehydration and anemia was revealed on blood analysis. On thoracic radiography and echocardiography, the patient showed pericardial effusion and ultrasound-guided pericardiocentesis was performed. A Rivalta test of the pericardial effusion showed a positive result. As the patient had recurrent pericardial effusion, pericardiectomy was performed. He was tentatively diagnosed with wet form feline infectious peritonitis (FIP) and treated with Polyprenyl immunostimulant (PI). Neurological signs were eventually seen and he was euthanized. Histopathologic changes with markedly expanded neutrophils, lymphocytes, plasma cells, and macrophages with fibrous connective tissue and collagenous fibers were detected. Immunohistochemistry for FIP antigen was performed and results showed FIPV-positive multifocal aggregates of cells. Pericardial effusion is an atypical condition in cats with FIP, but can be presented. This case report describes FIP with pericardial effusion in a cat, in which definitive diagnosis of FIP was done using biopsy via pericardiectomy.

• Journal of Chest Surgery
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• 제10권1호
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• pp.173-178
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• 1977

A 51 year old man was admitted to the Thoracic and Cardiovascular Department of Kyungpook University Hospital on April 7, 1976, with chief complaints of orthopnea and the chest pain for about 3 months. Physical examination showed narrow pulse pressure, puffy face, engorged neck veins at sitting position, distant heart sound, enlarged liver and edematous upper extremities. The chest roentgenogram demonstrated markedly enlarged cardiac silhouette. Low voltage and the low to diphagic T`s were noted on the electrocardiogram. Paroxysmal ventricular tachycardia was developed intermittently and was subsided spontaneously. Repeated pericardiocentesis were performed each of which yielded from 100 to 300ml. but intractable cardiac failure was progressed. The bacteriology and cytology of the pericardial fluid were not revealed any specific findings. The pericardiectomy was performed to release the intractable cardiac tamponade. Pericardium was found to be thickened and cardiac constriction was noted. The thickened pericardium was easily removed. A large hen`s egg sized dark blue tumor mass occupied the anterior wall of the right atrium and two thumb tip sized pearl gray tumors were placed at the just below portion of the main pulmonary artery. The biopsy report revealed primary fibrosarcoma of the heart. The patient was improved from the symptoms of the cardiac failure during the postoperative course.

• Journal of Chest Surgery
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• 제39권9호
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• pp.729-732
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• 2006

외상에 의하여 심장눌림증을 유발한 종격동 양성낭기형종 종격동 기형종은 전체 종격동 종양의 $8\sim13%$ 빈도로 발생하며, 대부분 우연히 발견되지만 드물게 심낭 천공이 발생하여 심장눌림증을 유발하거나, 흉막삼출액을 고이게 한다. 본 증례에서는 전흉벽 타박상을 받은 여자 환자에게서 심장눌림증이 발생하였고, 응급 방사선검사에서 종격전부 종양이 확인되었으며 심장막천자술을 받은 후 활력징후가 회복되어 추후 수술적 절제술로 종양을 적출하였다. 조직검사에서 피지선, 성숙 지방종, 위장관점막, 호흡기도 점막 및 췌장의 조직 등으로 구성된 낭포성 구조물로 관찰되어 양성 낭기형종으로 판정되었다.

• Journal of Chest Surgery
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• 제24권4호
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• pp.397-403
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• 1991

From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.