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Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Late pacemaker lead tip perforation documented by chest CT.

Neeraj Jain1, Vijay Ravipati2, Edmund K Kerut3

  • 1Section of Cardiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana. njain@lsuhsc.edu.

Echocardiography (Mount Kisco, N.Y.)
|August 23, 2016
PubMed
Summary

Late cardiac perforation by a pacemaker lead is difficult to diagnose. Chest CT effectively identifies lead migration, aiding in timely diagnosis and treatment.

Keywords:
CTStaphylococcus aureusechocardiographypurulent pericarditis

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Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Late cardiac perforation by a right ventricular (RV) pacemaker lead presents diagnostic challenges.
  • Standard echocardiography may not adequately visualize lead tip migration.

Observation:

  • A patient presented with fever, sepsis, and loss of RV pacer lead capture one month post-implantation.
  • Echocardiography revealed vegetations and pericardial effusion but could not pinpoint the lead tip.
  • Chest computed tomography (CT) clearly identified the lead tip migrated through the pericardium into the anterior mediastinum.

Findings:

  • Chest CT is a valuable tool for diagnosing late pacemaker lead cardiac perforation.
  • Combined echocardiography and CT findings facilitated diagnosis and therapeutic decisions.

Implications:

  • Accurate diagnosis of lead perforation is crucial for effective patient management.
  • CT imaging should be considered when lead migration is suspected despite inconclusive echocardiography.