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Pneumopericardium as a complication of pericardiocentesis.

Choi WH, Hwang YM, Park MY, Lee SJ, Lee HY, Kim SW, Jun BY, Min JS, Shin WS, Lee JM, Koh YS, Jeon HK, Chung WS, Seung KB - Korean Circ J (2011)

Bottom Line: Air-fluid level surrounding the heart shadow within the pericardium on a chest X-ray is an early observation at diagnosis.This clinical measurement and process is variable, depending on the hemodynamic status of the patient.The development of a cardiac tamponade is a serious complication, necessitating prompt recognition and treatment.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Pneumopericardium is a rare complication of pericardiocentesis, occurring either as a result of direct pleuro-pericardial communication or a leaky drainage system. Air-fluid level surrounding the heart shadow within the pericardium on a chest X-ray is an early observation at diagnosis. This clinical measurement and process is variable, depending on the hemodynamic status of the patient. The development of a cardiac tamponade is a serious complication, necessitating prompt recognition and treatment. We recently observed a case of pneumopericardium after a therapeutic pericardiocentesis in a 20-year-old man with tuberculous pericardial effusion.

No MeSH data available.


Related in: MedlinePlus

Chest X-ray on admission showed cardiomegaly with a clear lung.
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Figure 1: Chest X-ray on admission showed cardiomegaly with a clear lung.

Mentions: Posteroanterior chest radiographs showed cardiomegaly without any lung lesion (Fig. 1). An emergent echocardiogram showed a large circumferential pericardial effusion and diastolic right atrium collapse without respiratory variation of the mitral inflow. The left ventricular ejection fraction was estimated to be 60%. A 7Fr ARROWgard Blue® catheter (Arrow International Inc, Bernville, PA, USA) was used for subxiphoid pericardiocentesis. Over 1,000 mL of serous fluid was drained from the pericardial sac over the following 12 hours. Subsequently, the patient's resting dyspnea was resolved. Sputum and pericardial fluid cultures and smear for AFB and other organisms were negative. The pericardial fluid was a lymphocyte dominant exudate, containing protein 6.5 g/dL, albumin 3.6 g/dL, lactate dehydrogenase 466 U/L and white blood cell 7,200 cells/µL (lymphocyte 84%). Polymerase chain reaction for Mycobacterium tuberculosis deoxyribonucleic acid was negative with pericardial fluid and adenosine deaminase in pericardial effusion was 96 IU/L (normal, 5 to 23 IU/L).3)


Pneumopericardium as a complication of pericardiocentesis.

Choi WH, Hwang YM, Park MY, Lee SJ, Lee HY, Kim SW, Jun BY, Min JS, Shin WS, Lee JM, Koh YS, Jeon HK, Chung WS, Seung KB - Korean Circ J (2011)

Chest X-ray on admission showed cardiomegaly with a clear lung.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116108&req=5

Figure 1: Chest X-ray on admission showed cardiomegaly with a clear lung.
Mentions: Posteroanterior chest radiographs showed cardiomegaly without any lung lesion (Fig. 1). An emergent echocardiogram showed a large circumferential pericardial effusion and diastolic right atrium collapse without respiratory variation of the mitral inflow. The left ventricular ejection fraction was estimated to be 60%. A 7Fr ARROWgard Blue® catheter (Arrow International Inc, Bernville, PA, USA) was used for subxiphoid pericardiocentesis. Over 1,000 mL of serous fluid was drained from the pericardial sac over the following 12 hours. Subsequently, the patient's resting dyspnea was resolved. Sputum and pericardial fluid cultures and smear for AFB and other organisms were negative. The pericardial fluid was a lymphocyte dominant exudate, containing protein 6.5 g/dL, albumin 3.6 g/dL, lactate dehydrogenase 466 U/L and white blood cell 7,200 cells/µL (lymphocyte 84%). Polymerase chain reaction for Mycobacterium tuberculosis deoxyribonucleic acid was negative with pericardial fluid and adenosine deaminase in pericardial effusion was 96 IU/L (normal, 5 to 23 IU/L).3)

Bottom Line: Air-fluid level surrounding the heart shadow within the pericardium on a chest X-ray is an early observation at diagnosis.This clinical measurement and process is variable, depending on the hemodynamic status of the patient.The development of a cardiac tamponade is a serious complication, necessitating prompt recognition and treatment.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
Pneumopericardium is a rare complication of pericardiocentesis, occurring either as a result of direct pleuro-pericardial communication or a leaky drainage system. Air-fluid level surrounding the heart shadow within the pericardium on a chest X-ray is an early observation at diagnosis. This clinical measurement and process is variable, depending on the hemodynamic status of the patient. The development of a cardiac tamponade is a serious complication, necessitating prompt recognition and treatment. We recently observed a case of pneumopericardium after a therapeutic pericardiocentesis in a 20-year-old man with tuberculous pericardial effusion.

No MeSH data available.


Related in: MedlinePlus