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Pleural Effusion I: Introduction

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Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
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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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Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
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Pericarditis I: Introduction

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Concurrent pericardial and pleural effusions: a double jeopardy.

Branko Furst¹, Chyong-Jy J Liu¹, Philip Hansen¹

¹Department of Anesthesiology, Albany Medical College, 47 New Scotland Ave, MC-131, Albany, NY 12208, USA.

Journal of Clinical Anesthesia

|August 25, 2016

Summary

Large pleural and pericardial effusions can cause cardiac tamponade. Prioritizing pleural effusion drainage may prevent cardiovascular collapse during emergent procedures for these conditions.

Keywords:

Anesthesia Cardiovascular collapse Pericardial tamponade Pleural effusion Right ventricular failure

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Area of Science:

Cardiology
Thoracic Surgery
Oncology

Background:

Malignant pleural and pericardial effusions can lead to life-threatening conditions like cardiac tamponade and congestive heart failure.
Emergent procedures are often necessary to relieve pressure and improve hemodynamic stability.

Observation:

A 19-year-old male presented with large malignant pleural and pericardial effusions, experiencing tamponade physiology and congestive heart failure.
An emergent subxiphoid pericardial window procedure was complicated by paradoxical cardiovascular collapse unresponsive to standard interventions.
Median sternotomy revealed an intact heart, with arterial pressure restoring only after pleural effusion drainage.

Findings:

The case suggests that large pleural effusions, in conjunction with pericardial effusions, can significantly impair cardiac function and lead to cardiovascular collapse.
Drainage of the pleural effusion was the critical intervention that restored hemodynamic stability.

Implications:

In patients with combined tamponading pericardial and pleural effusions, prioritizing pleural effusion drainage is proposed.
This approach may prevent severe hemodynamic compromise during emergent interventions.
Understanding the pathophysiology of low cardiac output in such cases is crucial for clinical management.