Abstract
Introducción: El derrame pericárdico maligno es la acumulación de líquido en el espacio pericárdico secundario a neoplasias en estadios avanzados, siendo así, un indicador de mal pronóstico. Los tumores malignos que con mayor frecuencia se relacionan con esta entidad son los de origen pulmonar, mamario y hematolinfoides. Clínicamente puede cursar con signos inminentes de taponamiento cardiaco e inestabilidad hemodinámica, por lo que amerita un diagnóstico temprano y manejo urgente con maniobras de descompresión. Objetivo: Este articulo busca presentar un caso de derrame pericárdico maligno, debido a que esta condición clínica implica un reto diagnóstico. Presentación del caso y conclusiones: Presentamos el caso de un paciente masculino de 63 años de edad, con cuadro clínico de 1 mes de evolución, caracterizado por presencia de adenopatías cervicales, quien en los últimos 15 días presenta saciedad precoz, sudoración nocturna, sensación de distensión abdominal y deterioro de la clase funcional hasta disnea de pequeños esfuerzos, motivo por el cual consulta al servicio de urgencias. Durante la observación médica rápidamente progresa a inestabilidad hemodinámica, refractaria a manejo; se realizan estudios imagenológicos, en donde se evidencia derrame pericárdico severo, por lo que se procede a realizar pericardiocentesis descompresiva emergente y manejo integral multidisciplinario.
Highlights
Malignant pericardial effusion is the accumulation of liquid in the pericardial space secondary to advanced stage neoplasia, becoming in an indicator of bad prognosis
It should be noted that the Malignant pericardial effusion (MPE) is an indicator of poor prognosis; it can show some signs of impending cardiac tamponade and is clinically characterized by a hemodynamic instability secondary to increased pressure due to a pericardial fluid accumulation that requires emergent decompression maneuvers [7, 8]
On the second day after hospital discharge, the patient entered to the emergency department after approximately 48 hours. His clinical condition was characterized by pain in the right scapular region of 9/10 intensity according to the MPE is an indicator of poor prognosis and clinically, patients may present signs of impending cardiac tamponade which is associated with high mortality
Summary
Malignant pericardial effusion is the accumulation of liquid in the pericardial space secondary to advanced stage neoplasia, becoming in an indicator of bad prognosis. Malignant tumors that are most often related to this entity are the ones from pulmonary, mammary, and hematolymphoid origin It may present imminent signs of cardiac tamponade and hemodynamic instability, so that it merits an early diagnosis and management with emerging decompression maneuvers. Case presentation and Conclusions: A case of a 63 year old male patient is presented He has one month of clinical evolution characterized by cervical adenopathies, in the past fifteen days has been presenting precocious satiety, nocturnal sweating, sensation of distended abdomen, and functional class deterioration to having dyspnea during small physical efforts. It should be noted that the MPE is an indicator of poor prognosis; it can show some signs of impending cardiac tamponade and is clinically characterized by a hemodynamic instability secondary to increased pressure due to a pericardial fluid accumulation that requires emergent decompression maneuvers [7, 8]
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