Concurrent pericardial and pleural effusions: a double jeopardy

Furst, Branko; Liu, Chyong-jy J.; Hansen, Philip; Musuku, Sridhar Reddy

doi:10.1016/j.jclinane.2016.04.056

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Furst and colleagues proposed that, in patients presenting with both cardiac tamponade and massive pleural effusion, drainage of the pleural effusion should be given priority because sudden evacuation of the pericardial effusion leads to acute hemodynamic instability caused by failure of the right ventricle and decreased pulmonary circulation due to the large pleural effusion compressing the lung [6]. Furthermore, they described spontaneous respiration as essential to preserve the unstable hemodynamic state of the patient.…”

Section: Discussionmentioning

confidence: 99%

Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report

et al. 2019

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Background Pericardio-pleural fenestration by video-assisted thoracoscopic surgery is an efficient procedure for malignant pericardial effusion, but requires general anesthesia with single-lung ventilation. Case presentation A 43-year-old woman was referred with complaints of deteriorating dyspnea and orthopnea. Chest computed tomography revealed right massive pleural effusion and pericardial effusion. Echocardiography demonstrated collapse of both the right atrium and right ventricle due to cardiac tamponade. Semi-rigid thoracoscopic pleural biopsy and pericardio-pleural fenestration were successfully performed under local anesthesia via a single trocar, because surgical procedures under general anesthesia with single-lung ventilation might have been intolerable for the patient. Adequate biopsy specimens of pleura and pericardium and immediate relief of serious symptoms were obtained without perioperative complications. No recurrence of pleural or pericardial effusion was observed for 3 months postoperatively. Conclusion Thoracoscopic pericardio-pleural fenestration under local anesthesia via a single trocar is feasible as an alternative approach in critically ill patients, allowing effective pericardial drainage, evaluation of the pleural cavity, and accurate biopsies of the pericardium and parietal pleura simultaneously.

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Section: Discussionmentioning

confidence: 99%

Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report

et al. 2019

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“…Without a definitive etiology or specific clinical manifestations ( 3 ), early diagnosis and staging of PMPM may be difficult, particularly in the presence of concurrent pericardial and pleural effusions ( 4 – 9 ). Asbestos exposure is less frequently associated with pericardial mesothelioma compared with pleural mesothelioma, and it is not necessarily considered a risk factor for the development of pericardial mesothelioma.…”

Section: Discussionmentioning

confidence: 99%

18F‑fluorodeoxyglucose imaging of primary malignant pericardial mesothelioma with concurrent pericardial and pleural effusions and bone metastasis: A case report

Zhao

et al. 2018

mol clin onc

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Primary malignant pericardial mesothelioma (PMPM) is an aggressive tumor that originates from the mesothelial cells of the pericardium. PMPM with extensive atrial infiltration and bone metastasis is extremely rare. The diagnosis and staging of PMPM based on anatomical imaging may be difficult when concurrent pericardial and pleural effusions are present. A 28-year-old man presented with progressive chest pain. Concurrent pericardial and pleural effusions were identified on computed tomography. On echocardiography, mild thickening and adhesions of the pericardium with the right ventricle and atrium were observed. 18F-fluorodeoxyglucose (FDG) metabolism imaging revealed increased accumulation in the pericardium and adjacent right atrium. Ring-shaped radioactivity aggregation and bone destruction in the sacrum were demonstrated on 18F-FDG and 99mTc-methyl diphosphonate imaging. The diagnosis of PMPM was subsequently confirmed by pathology. The patient survived for >1.5 years with comprehensive treatment.

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“…Moreover, it has been shown that it is beneficial to drain the pericardial effusion first in individuals who present with tamponade, then the pleural effusion [ 7 ]. Most cases of pericardial effusion and pleural effusion can be diagnosed by analyzing the patient's medical history, physical exam, chest X-ray, and a diagnostic thoracentesis for pleural effusions [ 8 ]. In many cases, both pleural effusion and pericardial effusion can resolve on their own.…”

Section: Introductionmentioning

confidence: 99%

“…In many cases, both pleural effusion and pericardial effusion can resolve on their own. In severe cases, therapeutic thoracentesis is required for pleural effusions, and pericardiocentesis is required for pericardial effusions [ 8 ]. After severe pericardial effusion and pleural effusion are confirmed, pericardiocentesis should be performed immediately because it is a life-saving intervention for acute cardiac tamponade (with unstable hemodynamics).…”

Section: Introductionmentioning

confidence: 99%

Pleural and Pericardial Effusion With COVID-19 and Systemic Lupus Erythematosus and Its Recurrence: A Case Study

Yost¹,

Vercillo²,

Abuqare³

et al. 2023

Cureus

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As a chronic autoimmune disease, systemic lupus erythematosus (SLE) primarily affects young women and does not discriminate against any particular organs. In December 2019, coronavirus disease 2019 (COVID-19) spread worldwide, with many speculations of cardiac involvement in the pathogenesis of infection. Moreover, in cases where cardiac symptoms were described, they consisted solely of chest pain or a general deterioration in health if the patient presented with pleural effusion or pericardial effusion.Our patient, a 25-year-old Hispanic woman, initially complained of chest pain, cough, and shortness of breath. After being admitted, she noticed growing dyspnea and mild discomfort on the right side of her chest. The patient had both SLE and COVID-19 and had developed pleural and pericardial effusions. After two days in culture, nothing had grown from the fluid samples. In addition, measures of brain natriuretic peptide and total creatine kinase fell within the normal range. Considering the investigational findings, pericardiocentesis was performed. After the procedure, the patient's condition improved, and she was discharged. The patient continued taking CellCept® 1,500 mg and Plaquenil 200 mg and started taking colchicine. Her daily prednisone dose was increased to 40 milligrams. She felt well initially; however, after two weeks of follow-up, the pericardial effusion recurred, and pericardiocentesis was performed again. The patient was discharged in stable condition after a two-day hospital stay.After treatment of both initial and recurrent effusions, the patient's cardiac symptoms were resolved, and blood pressure became stable. We hypothesize that there may be other unreported cases of COVID-19related viral pericarditis, pericardial effusion, and pericardial tamponade that could be caused by a combination of COVID-19 and a pre-existing condition, mainly autoimmune disorders. Due to the lack of clarity surrounding typical COVID-19 manifestations, it is crucial to record all cases of this unique illness and analyze any increased incidence of pericarditis, pericardial effusion, and pericardial tamponade in the public.

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Concurrent pericardial and pleural effusions: a double jeopardy

Cited by 7 publications

References 18 publications

Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report

Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report

18F‑fluorodeoxyglucose imaging of primary malignant pericardial mesothelioma with concurrent pericardial and pleural effusions and bone metastasis: A case report

Pleural and Pericardial Effusion With COVID-19 and Systemic Lupus Erythematosus and Its Recurrence: A Case Study

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