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infected malignant pericardial and pleural effusion

added by Emmel

infected malignant pericardial and pleural effusion
Posted By: Emmel (2277 days ago)


there was no condition after sterniotomy, but a
condition after making a trans-diaphragmal fistula between pericardial
effusion and peritoneal cavity (unfortunately there were no documents/
results available). In that echocardiographic study I found NO
peritoneal effusion so I conclused that there is an occlusion of that
fistula. You are very right, that pericardial effusion isn´t
circular. In my opinion is that because of malignant fibrinoid
Best wishes,

Posted By: drdavemd (2277 days ago)

Looks loculated, not much fluid in the posterior aspect, any history
of prior sternotomy?

Posted By: Emmel (2282 days ago)

Hi Pablo!

You are right: there is no swimming heart; there
is a high fluid density, because there are many inflammatory and
malignant cells in. The patient died 12 hours after admission and
tipping the effusion.
AFter that the culture was positive with
gram-positive coccal-cells and malignant cells corresponding to known
lung cancer.

Posted By: ohtusabes (2283 days ago)

Great clip my friend.!

Is amazing the LV cavity...very
small and hyperkinetic because of very low preload... LVH?
/>The sign I note is a stiff whole heart...no swinging heart...this
will be because of fluid density? how many fluid was drained? Electric
alternans in ecg?

The pericardial fluid culture was

Very bad prognosis, poor man!

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Added: 19-04-2012
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about 60 y old patient with known metastasised lung cancer with condition after radiatio and chemotherapy but with distinct progress under that therapy. The patient was admitted to our ER with severe dyspnoe, tachykardia, hypotension, \"kussmaul\"-sign (inspiratory dilated jugular veins) and peripheral low voltage in ECG. In TTE we could see a pleural and pericardial severe effusion with signs of tampoonade (collapse of RA and RV, undulation of transtricuspidal flow > 45%) and dilated IVC. The results of tapping showed an infection (> 500 leucocytes/µl and malignant cells).

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