China
Africa
Explore chapters and articles related to this topic
Thoracic Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
An eFAST (Extended Focused Abdominal Sonography for Trauma) is helpful as an additional assessment tool. The eFAST includes the abdomen for haemoperitoneum, since concomitant intra-abdominal injuries may be present, the precordium for haemopericardium and the chest for lung sliding. Chest wall emphysema may preclude adequate windows for a technically reliable examination. Rapid assessment for the presence of haemopericardium and haemoperitoneum will drive management and operative decisions. There is an important caveat when performing eFAST: it is unreliable in the presence of a haemothorax. A lacerated pericardium with an associated cardiac injury can allow blood to decompress into the plural space. The absence of haemopericardium on eFAST may be incorrectly interpreted as excluding a cardiac injury. In this circumstance, a pericardial window is performed; if positive, it is extended to a median sternotomy.
Subxiphoid Pericardiotomy versus Echocardiography: A Prospective Evaluation of the Diagnosis of Occult Penetrating Cardiac Injury
Published in Stephen M Cohn, Ara J. Feinstein, 50 Landmark Papers every Trauma Surgeon Should Know, 2019
E Jimenez, M Martin, I Krukenkamp, Barrett J. Surgery
False negatives must be avoided as this can result in time and effort wasted pursuing incorrect diagnoses. Following a false negative study, reconsideration of the diagnoses of hemopericardium and even tamponade tends to be neglected, most notably in an otherwise healthy patient with stout physiologic reserve and persistent tachycardia. This error is minimized by keeping the diagnosis in mind and repeating the echo or exploring the pericardium. Trace hemopericardium is easily missed on echo but can lead to the development of pericarditis and increasing pericardial effusion or may lead to tamponade in the setting of a slow or delayed intrapericardial bleed.
H
Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Hemopericardium [Greek: haima, blood + peri, around + kardia, heart] Blood in the pericardial sac. One of the first instances of cardiac tamponade was described by Berlin physician, Edmund Rose (1836–1914).
Rare case of primary pericardial angiosarcoma
Published in Acta Cardiologica, 2021
Bryan E-Xin Tan, Mohammad Abu Sheikha, Medhat Chowdhury, Adnan Kharsa, Mallory Balmer-Swain
A 48-year-old man presented with chest pain, dyspnoea, and cough with haemoptysis for one week. He had a history of unexplained hemopericardium requiring pericardiocentesis two months ago. TTE showed an echo density near the right atrium. Chest computed tomography (CT) with contrast showed a right-sided pericardial mass measuring 6 cm × 5 cm × 4 cm, and bilateral patchy lung nodules (Figure 1). Transesophageal echocardiography (TEE) and cardiac magnetic resonance imaging (MRI) showed a right pericardial mass (Figures 2 and 3). The patient underwent open biopsy, which revealed poorly differentiated malignant cell population demonstrating vasoformative features (Figure 4). By immunohistochemistry, the malignant cells were strongly positive for CD31, CD34, ERG, and FLI-1 (Figure 5). Findings were consistent with poorly differentiated angiosarcoma of pericardium. A wedge excisional biopsy of lung lesions was consistent with metastatic angiosarcoma. He was started on chemotherapy with doxorubicin and passed away after a prolonged hospital course.
Current practice in atrial septal defect occlusion in children and adults
Published in Expert Review of Cardiovascular Therapy, 2020
Wail Alkashkari, Saad Albugami, Ziyad M. Hijazi
With nearly 45 years after the first case of transcatheter ASD closure performed by King and Mills in New Orleans, the procedure has become an accepted first choice for majority of patients with an appropriate secundum atrial septal defect. The procedure is safe and effective. However, there is a finite risk of disastrous complications and that is device erosion with hemopericardium and on very rare occasion death. The major issue with this fearful complication is the inability to predict its timing. Some cases of erosions occurred years (after 9 years) after implantation of the device. We know that there are certain risk factors that may predispose to it, such as patients with deficient anterior/superior rim who receive an oversized device (oversizing by more than 150% of the true defect size). However, even with that, we truly cannot predict the timing of this complication, and not all patients who receive an oversized device encounter this complications. Unfortunately, our surgical colleagues claim that what we see now is only the tip of the iceburg! Of course as I mentioned with now over 20 years of experience with the most modern device (Amplatzer), the rate of erison remains extremely low at about 2–3 per 1000 cases.
Cardiac tamponade secondary to iatrogenic needle decompression in blunt force trauma
Published in Baylor University Medical Center Proceedings, 2022
Zaheer Faizi, Joseph Morales, Joseph Hlopak, Amber Batool, Asanthi Ratnasekera
Subsequently, during computed tomography (CT) scans of the head, neck, chest, abdomen, and pelvis, the patient underwent cardiac arrest with initiation of cardiopulmonary resuscitation. CT of the chest demonstrated a hemopericardium (Figure 1b). A left anterolateral resuscitative ED thoracotomy was performed. The pericardium appeared very tense. A pericardiotomy was performed with evacuation of blood clot. With intracardiac epinephrine and cardiac massage, return of spontaneous circulation was achieved after 12 minutes of resuscitation. The patient was then transferred to the operating room for further evaluation.