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Cardiovascular Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Pericardial drainage is required for tamponade. This can be carried out by direct puncture (pericardiocentesis), which can help in the diagnosis of a potentially infected pericardial effusion. Surgical drainage may be indicated for malignant pericardial effusions or when an effusion reaccumulates.
Cardiorespiratory system
Published in Helen Butler, Neel Sharma, Tiago Villanueva, Student Success in Anatomy - SBAs and EMQs, 2022
33 The following statements are all correct with regard to the pericardium EXCEPT: The pericardium is located in the middle mediastinum.The pericardium has fibrous and serous layers.The pericardial sac encases the heart, which is surrounded bysmall volume (approximately 50 mL) of fluid.Pericardial sinuses exist between the pericardium and the surface of the heart.The heart sits within the pericardium in the superior mediastinum.
Thoracic Injury Management
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
David R. King, James V. O’Connor
The chest is opened through a left anterolateral incision, with extension as a clamshell. Compared to the anterolateral incision, the clamshell affords superior cardiac exposure, especially of the SVC, IVC, and right atrium. It also allows the heart to be more easily delivered out of the pericardium.
Advances in multi-modality imaging for constrictive pericarditis and pericardial inflammation: role of imaging-guided therapy
Published in Expert Review of Cardiovascular Therapy, 2023
Tahir S Kafil, Tom Kai Ming Wang, Ankit Agrawal, Muhammad Majid, Alveena B Syed, Erika Hutt, Ben Alencherry, Joshua A Cohen, Sachin Kumar, Agam Bansal, Brian P Griffin, Allan L Klein
The pericardium is the fluid-filled, fibro-serous double-walled sac that encloses the heart and great vessels as they emerge from the pericardium. It is made up of visceral pericardium or inner serosal layer and parietal pericardium or outer fibrosa layer [9,10]. It anchors the heart in the anteromedial thorax and has copiousness of fibrous tissue in the fibrosa layer and a thin layer of mesothelial cells in the serosa layer [9,10]. There is 10–50 mL of serous fluid in between two layers which permits smooth cardiac motion [9,10]. The two layers (visceral and parietal layer) that are elastic and can stretch easily at low stress [3]. With inspiration, there is a decrease in intrathoracic pressure causing more venous blood to return to the right atrium and ventricle, causing the right ventricle to increase in size. The pericardium adjusts accordingly around the right ventricle, thus the enlarging right ventricle does not impinge on the adjacent left ventricle [3].
Sarcoidosis presenting as acute pericarditis. A case report and review of pericardial sarcoidosis
Published in Acta Cardiologica, 2022
Alexandre Unger, Philippe Unger, Raphaël Mottale, Mihaela Amzulescu, Abraham J. Beun
To the best of our knowledge, this is the second case of a patient presenting with clinical features consistent with acute pericarditis as the first manifestation of sarcoidosis [5]. The diagnosis of sarcoidosis requires clinical, radiological and pathological assessment. In this case, the diagnosis was ascertained by the findings of non-caseous granulomatosis on mediastinal lymph node biopsy and by the uptake pattern on PET/CT. Other infectious causes were excluded by an extensive work-up including serology and microbiological analysis of the biopsy sample. The findings of ANA with anti-SSA specificity and rheumatoid factor, in the absence of auto-immune disease is likely explained by an exaggerated immune response [6]. The combination of typical pericardial chest pain, widespread concave ST elevation and pericardial effusion is consistent with the diagnosis of acute pericarditis [7]. MRI was vital in ruling out myocardial involvement. Furthermore, no ECG or wall motion abnormality suggestive of myocardial sarcoidosis could be detected after the acute event [8].
Acute purulent pericarditis treated conservatively with intrapericardial fibrinolysis and intrapericardial and systemic antibiotics
Published in Baylor University Medical Center Proceedings, 2021
Mahmoud Abdelnabi, Abdallah Almaghraby, Yehia Saleh, Alyaa El Sayed, Judy Rizk
Purulent pericarditis is typically present as an acute illness characterized by high-grade fever, tachycardia, cough, and less commonly chest pain. In the postoperative setting, most patients with purulent pericarditis also have signs of mediastinitis or sternal wound infection. Cardiac tamponade may also occur.3S. aureus is the most common implicated pathogen, while Streptococcus pneumoniae is the most common organism in the setting of direct extension of an intrathoracic infection. Other causes include gram-positive organisms, fungi, and Mycobacterium tuberculosis. Polymicrobial infections are uncommon.4–6 Pericardial fluid analysis including chemical testing (for protein and glucose content as well as white cell count), microscopy (gram stain, acid-fast stain, and fungal stain), and culture and sensitivity is the mainstay for the diagnosis of purulent pericarditis.7