Project description:In this case report, we describe isolated left ventricular cardiac tamponade, a rare complication of cardiac surgery, diagnosed on point-of-care ultrasound (POCUS) in the emergency department (ED). To our knowledge, this is the first report of such a diagnosis made on ED bedside ultrasound. Our patient was a young adult female with a history of recent mitral valve replacement who presented to the ED with dyspnea and was found to have a large loculated pericardial effusion causing left ventricular diastolic collapse. Rapid diagnosis via POCUS in the ED allowed for expedited definitive treatment by cardiothoracic surgery in the operative room and emphasizes the importance of a standard 5-view cardiac POCUS examination when post-cardiac surgery patients present to the ED.

| S-EPMC10324463 | biostudies-literature

Hemorrhagic cardiac tamponade complicated by acute type A aortic dissection: A case report with critical care ultrasound findings.

Project description:RationaleAcute type A aortic dissection (AAAD) is a potentially fatal clinical crisis. Hemorrhagic cardiac tamponade due to the rupture of an ascending aortic root dissection is extremely dangerous and often lacks timely clinical evidence. We report sudden death in a patient diagnosed with AAAD and in whom critical care ultrasound highly indicated hemorrhagic cardiac tamponade.Presenting concernsA 75-year-old man was admitted to our emergency department with a complaint of chest pain for 8 hours. Computed tomography angiography findings indicated AAAD with a wide range of lesions. During the preoperative preparation process, he suddenly lost consciousness with a pulseless femoral artery.Diagnoses: Cardiopulmonary resuscitation was initiated and critical care ultrasound revealed hemorrhagic cardiac tamponade, strongly indicating the rupture of an ascending aortic root dissection.InterventionsHowever, family members refused further surgical interventions.OutcomesThe etiology could not be reversed and the patient died.LessonsCritical care ultrasound is an important skill that intensivists should master for fast screening of life-threatening complications in patients with AAAD.

| S-EPMC5728849 | biostudies-literature

Tamponade: To Be or Not to Be? Using Point-of-Care Ultrasound to Answer the Question.

Project description: Not available

| S-EPMC9399526 | biostudies-literature

The Role of Point-of-Care Ultrasound in the Emergency Department: The Case of a Contained Rupture of the Ascending Aorta Due to Type A Dissection Causing Subacute Cardiac Tamponade.

Project description: Not available

| S-EPMC9399628 | biostudies-literature

A Case Report of Cardiac Tamponade.

Project description:Cardiac tamponade is a rare and life-threatening condition that can be caused by trauma and various medical conditions. Failure to recognize and repair it quickly could lead to significant morbidity or even death. This case demonstrates the electrocardiogram (ECG) findings of low voltage QRS and electrical alternans in cardiac tamponade. It also highlights the classic ultrasound (US) findings of pericardial effusion and right ventricular collapse during diastole in cardiac tamponade. Classic physical exam findings of cardiac tamponade include Beck's Triad (jugular venous distention, hypotension, and muffled heart sounds) and pulsus paradoxus. This patient only had jugular venous distention and pulsus paradoxus. The case is centered on a 52-year-old male who presented with shortness of breath, wheezing, and a productive cough with streaks of blood. A CT chest was performed which revealed a large pericardial effusion, right upper lobe lung mass, and bilateral pulmonary emboli. A bedside transthoracic echocardiogram was then performed which confirmed the large effusion as well as right ventricular collapse during diastole. Cardiothoracic surgery and interventional cardiology were consulted and both agreed to take the patient to the cardiac catheterization lab for percutaneous drainage of the effusion. Pericardiocentesis was performed and 1.7 liters of serosanguinous fluid was removed and a drain was left in place. He recovered well from the procedure and had an uneventful admission. After reviewing this case, learners should be able to recognize the diagnostic features and various causes of pericardial effusion and cardiac tamponade.TopicsElectrocardiography, echocardiography, cardiac tamponade.

| S-EPMC10332784 | biostudies-literature

Cardiac metastasis mimicking STEMI-impact of point-of-care ultrasound on clinical decision-making: A case report.

Project description:IntroductionThe manifestations of cardiac metastases are extremely variable depending on their location and extension.Case presentationA 62-year-old man was admitted to the cardiac emergency department presenting with chest pain, worsening shortness of breath and palpitations. He had a history of esophageal squamous cell carcinoma treated with chemoradiotherapy, and he was not diagnosed with cardiovascular disease before. The electrocardiogram showed significant ST-segment elevations in leads II, III, and aVF. Initially, the patient was diagnosed with ST-segment elevation myocardial infarction. A cardiac point-of-care ultrasound was performed immediately revealing two large heterogeneous masses in the left ventricular wall and the apex, which changed the diagnosis and the management strategy. There was no significant change in serial cardiac biomarkers in the setting of persistent STE. Thoracic computed tomography and cardiac magnetic resonance confirmed that the patient was suffering from cardiac and lung metastases.ConclusionECG findings of localized and prolonged STE without Q waves or changes in biomarkers may suggest myocardial tumor invasion, especially in the cancer setting. Cardiac point-of-care ultrasound is an effective, convenient, noninvasive imaging modality to guide real-time clinical decision-making.

| S-EPMC10073711 | biostudies-literature

Point-of-Care Ultrasound: A Case Series of Potential Pitfalls

Project description:Graphical abstract Highlights • Integration of POCUS findings in the clinical context is crucial.• Valvular abnormalities may not be identified by POCUS.• Valvular disease should not be excluded based solely on a POCUS.• Careful review of POCUS studies in real time may help mitigate some POCUS pitfalls.

| S-EPMC9399537 | biostudies-literature

Definitive Advantages of Point-of-Care Ultrasound: A Case Series

Project description:Graphical abstract Highlights • We describe 4 cases where POCUS changed or aided in diagnosis.• POCUS often provides useful information in patients in shock.• Serial POCUS can assess changes over time in the ICU.

| S-EPMC9399626 | biostudies-literature

Diagnostic Utility of Point-of-Care Ultrasound in the Pediatric Cardiac Intensive Care Unit.

Project description:Purpose of reviewThis review summarizes the diverse uses of point-of-care ultrasound (POCUS) in critically ill children with congenital and acquired heart disease. Diagnostic utility and practicality of POCUS is reviewed. Importantly, the role of POCUS in the medical management of children in the cardiac intensive care unit is highlighted.Recent findingsThe use of POCUS in critically ill pediatric patients has emerged as an essential diagnostic tool that enhances the physical examination and influences delivery of care. Assessment of a wide range of body systems and pathologies has been impacted by the use of POCUS. Recent studies have demonstrated the use of POCUS for evaluation of cardiac tamponade, pneumonia, vocal cord function, and loss of muscle mass in critically ill children (Hamilton et al. Pediatr Crit Care Med 22(10):e532-e539, 2021; Hoffmann et al. Pediatr Crit Care Med 22(10):889-897, 2021; Najgrodzka et al. Ultrasound Q 35(2):157 163, 2019; Alerhand et al. Pediatr Ann 50(10):e424-e431, 2021).SummaryPOCUS is a non-invasive, low-risk, imaging modality that can be used to diagnose and help guide management of critically ill children in the cardiac intensive care unit. POCUS can be performed by an intensivist at the patient's bedside with real-time interpretation, leading to rapid clinical decision-making and the hope of improving patient outcomes.Supplementary informationThe online version contains supplementary material available at 10.1007/s40746-022-00250-1.

| S-EPMC9264295 | biostudies-literature

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