Humans ; Cardiac Tamponade/therapy* ; Acupuncture Therapy/adverse effects* ; Punctures/adverse effects* ; Heart

Aged ; Carcinoma, Hepatocellular ; therapy ; Cardiac Tamponade ; etiology ; therapy ; Catheter Ablation ; adverse effects ; Female ; Humans ; Liver Neoplasms ; therapy

The paraneoplastic nephrotic syndrome can be diagnosed by clinical and immunologic features. We have had a case of paraneoplastic nephrotic syndrome in the patients with aadeno-carcinoma of the lung, whose diagnosis was made by excluding other causes of nephrotic syndrome. The type of renal lesion was membranous glomerulopathy which commonly occurs in carcinoma. The quantity of proteinuria in this patient had decreased according to the improvement of lung cancer with combination chemotherapy. After fourth chemotherapy he was refractory to treatment, and unfortunately he had passed away with cardiac tamponade.
Adenocarcinoma* ; Cardiac Tamponade ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Glomerulonephritis, Membranous* ; Humans ; Lung Neoplasms ; Lung* ; Nephrotic Syndrome ; Paraneoplastic Syndromes ; Proteinuria

Objective: To evaluate the effect of Li's catheter in cardiac resynchronization therapy (CRT) implantation. Methods: This study was a retrospective cohort study. Patients with indications for CRT implantation who visited the Department of Cardiology, Peking University People's Hospital from January 1, 2016 to January 1, 2022 were enrolled. Patients were divided into Li's catheter group (CRT implantation with Li's catheter) and control group (CRT implantation with the traditional method). The general clinical data of the patients were obtained through the electronic medical record system. Li's catheter is a new type of coronary sinus angiography balloon catheter independently developed by Dr. Li Xuebin (patent number: 201320413174.1). The primary outcome was the success rate of CRT device implantation, and the secondary outcomes included efficacy and safety parameters. Efficacy indicators included operation time, coronary sinus angiography time, left ventricular lead implantation time, X-ray exposure time, left ventricular lead threshold, and diaphragm stimulation. Safety outcomes included incidence of coronary sinus dissection, cardiac tamponade, and pericardial effusion. Results: A total of 170 patients were enrolled in this study, including 90 in Li's catheter group and 80 in control group. Age, male proportion of patients, proportion of patients with ischemic cardiomyopathy, hypertension, diabetes mellitus, chronic renal insufficiency, New York Heart Association (NYHA) functional classification, left ventricular ejection fraction, left ventricular end-diastolic diameter, proportion of left bundle branch block, and preoperative QRS wave width were similar between the two groups (all P>0.05). In Li's catheter group, 34 cases (37.8%) implanted with CRT defibrillators, and 28 cases (35.0%) implanted with CRT defibrillators in control group, the difference was not statistically significant (P=0.710). The success rate of CRT device implantation in Li's catheter group was 100% (90/90), which was significantly higher than that in control group (93.8%, 75/80, P=0.023).The operation time was 57.0 (52.0, 62.3) minutes, the time to complete coronary sinus angiography was 8.0 (6.0, 9.0) minutes, and the time of left ventricular electrode implantation was 8.0 (7.0, 9.0) minutes in Li's catheter group, and was 91.3 (86.3, 97.0), 18.0 (16.0, 20.0), 25.0 (22.0, 27.7) minutes respectively in control group, all significantly shorter in Li's catheter group (all P<0.05). The exposure time of X-ray was 15.0 (14.0, 17.0) minutes in Li's catheter group, which was also significantly shorter than that in control group (32.5 (29.0, 36.0) minutes, P<0.001). There was no coronary sinus dissection and cardiac tamponade in Li's catheter group, and 1 patient (1.1%) had diaphragmatic stimulation in Li's catheter group. In control group, 6 patients (6.7%) had coronary sinus dissection, and 1 patient (1.1%) developed pericardial effusion, and 3 patients (3.3%) had diaphragmatic stimulation. The incidence of coronary sinus dissection in Li's catheter group was significantly lower than that in control group (P=0.011). The postoperative left ventricular thresholds in Li's catheter group and control group were similar (1.80 (1.60, 2.38) V/0.5 ms vs. 1.80 (1.60, 2.40) V/0.5 ms, P=0.120). Conclusions: Use of Li's catheter is associated with higher success rate of CRT implantation, short time of coronary sinus angiography and left ventricular electrode implantation, reduction of intraoperative X-ray exposure, and lower incidence of coronary vein dissection in this patient cohort.
Cardiac Resynchronization Therapy/methods* ; Cardiac Tamponade/therapy* ; Catheters ; Heart Failure/therapy* ; Humans ; Male ; Pericardial Effusion ; Retrospective Studies ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left

Primary pericardial malignant mesothelioma (PPM) is a very rare malignancy, with an incidence of less than 0.002% and represents less than 5% of all mesotheliomas. The cause of pericardial mesothelioma is uncertain that differ from pleural mesothelioma which is associated with asbestos exposure. This malignancy is terribly aggressive and has very poor prognosis with less than six months of overall survival. We present a case of a 71-year-old woman who was diagnosed with cardiac tamponade caused by PPM and received chemotherapy with pemetrexed and cisplatin for six months. During two years she was alive without disease progression. To better understand the clinical, pathologic features and treatment outcome of this entity, we reviewed 23 cases described in the English literature from 2009, together with our case, provided a total of 24 cases. Based on this review, we suggest that PPM must be considered in patients who have unexplained massive pericardial effusion and recommend chemotherapy with pemetrexed and cisplatin for the better outcome of PPM.
Aged ; Asbestos ; Cardiac Tamponade ; Cisplatin* ; Disease Progression ; Drug Therapy ; Female ; Humans ; Incidence ; Mesothelioma* ; Pemetrexed* ; Pericardial Effusion ; Prognosis ; Treatment Outcome

Atrial Fibrillation ; therapy ; Cardiac Tamponade ; etiology ; surgery ; Catheter Ablation ; adverse effects ; Emergency Treatment ; Humans ; Male ; Middle Aged

We report a case of 62-year-old man with cardiac tamponade due to coronary artery injury after acupuncture into the substernum. After resuscitation of cardiac arrest, we performed emergent pericardiocentesis. Nevertheless, the cardiac arrest recurred, and the emergent operation on cardiopulmonary bypass was performed. We identified hemopericardium due to shredded acute marginal branch of right coronary artery, and it was ligated leading to termination of bleeding. The patient was discharged without any other complications.
Acupuncture Therapy/*adverse effects ; Cardiac Tamponade/*diagnosis/etiology ; Coronary Vessels/*injuries ; Humans ; Male ; Middle Aged ; Pericardial Effusion/*diagnosis/etiology

Acupuncture is considered a relatively safe procedure. However, there are serious adverse effects; neurological damage, pneumothorax, cardiac tamponade, serum hepatitis, bacterial and viral infections may occur. Cardiac tamponade is considered to be a rare adverse effect of acupuncture. In the following case, cardiac tamponade was caused by epigastric acupuncture. A 78-year-old male was admitted with a chief complaint of drowsy mentality and hypotension, suggesting a status of shock. He had received acupuncture therapy over epigastric area for gastric dyspepsia at a local oriental medical clinic. An abdominal CT scan and chest x-ray showed a hemopericardium. After receiving pericardiocentesis, his clinical condition improved immediately. He was short in stature and slender for his age. Chest x-ray and computed tomography showed cardiomegaly and pectus excavatum. A proper use of acupuncture by a skilled medical provider is essential to avoid serious complications.
Acupuncture ; Acupuncture Therapy ; Aged ; Cardiac Tamponade ; Cardiomegaly ; Dyspepsia ; Funnel Chest ; Hepatitis ; Humans ; Hypotension ; Male ; Pericardial Effusion ; Pericardiocentesis ; Pneumothorax ; Shock ; Thorax

Percutaneous pericardiocentesis guided by two-dimensional echocardiography was introduced in 1983 as an alternative to electrocardiographically or fluoroscopically guided puncture for the management of pericardial effusion. The objective of this study was to investigate echocardiographically (echo) - guided pericardiocenteses performed at Yonsei Cardiovascular Center from January 1, 1993 to December 31, 2003, and also to determine whether patient profiles, etiology, and practice patterns have changed over this 11-year period. The medical records of 272 patients were examined and a follow-up survey was conducted. Patient clinical profiles, etiology, echocardiographic findings, and procedural details were determined for 2 periods: January, 1993 through December, 1997 (period 1) ; and January 1998 through December, 2003 (period 2). During the 11-year study period, 291 therapeutic, echo-guided pericardiocenteses with pericardial catheter drainage were performed in 272 patients. The number of pericardiocentesis in period 2 was increased compared with period 1 (191 cases vs. 100 cases). The mean age at pericardiocentesis increased from 49 +/-17 years in period 1 to 55+/-16 years in period 2 (p< 0.05). The procedural success rate was 99% overall with a major complication rate of 0.7% (2 cases of right ventricular free wall perforation which required emergency operation). Only one procedure-related mortality (< 30 days) was noted. Malignancy was the leading cause of a pericardial effusion requiring pericardiocentesis (45.6%). The incidence of pericardial effusion following cardiothoracic surgery and percutaneous coronary intervention procedures accounted for nearly 20% of all pericardiocenteses performed. Echo-guided pericardiocentesis has become a safe, standard practice for clinically significant pericardial effusion, in line with the changes of patients profiles over the 11 years of the study.
Adult ; Aged ; Cardiac Tamponade/therapy/ultrasonography ; Drainage ; *Echocardiography ; Female ; Human ; Male ; Middle Aged ; Pericardial Effusion/*therapy/*ultrasonography ; Pericardiocentesis/adverse effects/*methods ; Retrospective Studies ; Treatment Outcome

The heart may be critically damaged by objects of unimpressive size or appearance. We report a case of cardiac tamponade due to penetration of the right ventricle by an acupunture needle. A 59-year-old man was admitted due to dyspnea and chest pain. He had recieved acupuncture therapy during 10 years for chronic right upper abdominal pain. He was diagnosed as cardiac tamponade due to hemopericardium caused by an broken a cupuncture needle detected on fluoroscopy, computerized tomography and trans-esophageal echocardiography, and the needle was successfully removed by cardiac surgery. The patient was discharged uneventfully and followed at the outpatient department.
Abdominal Pain ; Acupuncture Therapy ; Cardiac Tamponade* ; Chest Pain ; Dyspnea ; Echocardiography ; Fluoroscopy ; Heart ; Heart Ventricles ; Humans ; Middle Aged ; Needles* ; Outpatients ; Pericardial Effusion ; Thoracic Surgery