obsolete pneumopericardium

Obsolete Pneumopericardium

Pneumopericardium, also known as air in the pericardial sac, was once considered an obsolete condition due to its rarity and limited clinical significance.

• Definition: Obsolete pneumopericardium refers to a condition where there is an accumulation of air or gas in the space between the heart and the pericardium (the membrane surrounding the heart).
• Causes: This condition was previously thought to be caused by various factors, including trauma, infections, and iatrogenic procedures. However, with advancements in medical knowledge, it has been recognized that pneumopericardium is a rare but serious entity that can result from more severe conditions.
• Clinical Presentation: Patients with obsolete pneumopericardium may present with variable symptoms, ranging from asymptomatic to life-threatening complications such as pericardial tamponade.

Current Understanding

With the advent of modern medical research and advancements in diagnostic techniques, pneumopericardium is no longer considered an obsolete condition. It is now recognized as a rare but serious entity that requires prompt diagnosis and treatment to prevent life-threatening complications (11, 13).

According to recent studies, pneumopericardium is defined as an accumulation of air-fluid level in the pericardial cavity, which can be caused by various factors such as trauma, infections, iatrogenic procedures, or abnormal communications between the pericardium and hollow organs (11). This condition can lead to serious complications, including pericardial tamponade, which requires rapid diagnosis and treatment (12).

References

[6] - pneumopericardium. Human disease. obsolete pneumopericardium. [13] - Keywords: pneumopericardium, tamponade, blunt trauma, cardiothoracic. Introduction. A pneumopericardium is defined as the presence of air or gas in the pericardial sac.

Clinical Presentation of Pneumopericardium

Pneumopericardium, a rare clinical condition characterized by the presence of air in the pericardial sac, can manifest with various signs and symptoms. While it may initially be asymptomatic, the accumulation of sufficient air can lead to cardiac tamponade, a life-threatening condition.

Classic Signs and Symptoms

• Mill wheel murmur: A distinctive sound heard as a succession splash and traducing shaking movement of the heart within pericardial cavity, considered pathognomonic for pneumopericardium (4, 14).
• Cardiac auscultation: Abnormal sounds may be detected upon listening to the heart with a stethoscope.
• Respiratory distress: Symptoms such as grunting, mild subcostal retractions, tachypnea, and absent dorsal lung sounds bilaterally can occur (8).

Other Possible Signs and Symptoms

• Hypotension: Low blood pressure may be present due to cardiac tamponade.
• Cyanosis: A bluish discoloration of the skin and mucous membranes can occur in severe cases.
• Tachycardia or bradycardia: Abnormal heart rates may be observed.

Important Considerations

• Pneumopericardium can mimic cardiac tamponade, making it essential to consider this condition in patients presenting with acute cardiopulmonary symptoms (13).
• The presence of gas in the pericardial space is a negative prognosis factor itself, emphasizing the need for prompt and accurate diagnosis.

References

(4) by D BIANCHI PINTOS · 2020 · Cited by 2 (8) Apr 27, 2018 (13) Mar 17, 2023 (14) by RW Emery · 1984 · Cited by 29

Based on the provided context, it appears that there are various treatment options for pneumopericardium, including drug therapy.

According to search result [10], one of the treatment options mentioned is oxygen therapy in high concentrations to aid in the absorption of air. However, this option seems more relevant to small or asymptomatic cases (search result [14]).

For larger and symptomatic cases, the definitive treatment involves drainage of air surrounding the pericardium (search result [14]). This may involve surgical intervention or other medical procedures.

Regarding drug treatment specifically for pneumopericardium, there is limited information available in the provided context. However, search result [3] mentions that a patient with a different condition was treated with dexamethasone 8 mg daily, meropenem (1 g every 8 hours), Targocid 400 mg daily, and ASA 80 mg.

It's essential to note that this information might not be directly related to the treatment of pneumopericardium. However, it does suggest that various medications may be used in conjunction with other treatments for different conditions affecting the pericardial sac.

In terms of obsolete drug treatment for pneumopericardium, there is limited information available in the provided context. However, search result [5] mentions that Pneumopericardium should be treated initially by emergency pericardial aspiration to relieve symptoms of tamponade and then by placement of an anterior pericardial window.

It's worth noting that this treatment approach may not be considered "obsolete" in the classical sense but rather a historical or outdated method. However, without more specific information on drug treatments for pneumopericardium, it is challenging to provide a definitive answer.

If you're looking for more up-to-date information on drug treatments for pneumopericardium, I recommend searching for more recent studies or clinical guidelines on the topic.

Pneumopericardium, an accumulation of air in the pericardial cavity, was a rare condition that has been reported to result from various causes, including spontaneous or iatrogenic factors. In the past, differential diagnosis of pneumopericardium involved considering several conditions that presented with similar symptoms.

According to medical literature [10], when difficulties arose in visualizing the heart by conventional echocardiography, pneumopericardium should be taken into account as a potential cause. This condition was associated with a high mortality rate and required rapid diagnosis and treatment.

In the differential diagnosis of chest pain, pneumopericardium was considered alongside other conditions such as pericarditis, myocardial infarction, and pulmonary embolism [13]. The presence of air-fluid level in the pericardial sac was a key diagnostic feature of pneumopericardium.

Other conditions that were considered in the differential diagnosis of pneumopericardium included:

• Pericardiocentesis: This was a procedure used to remove fluid from the pericardial space, and it was often performed in cases where pneumopericardium was suspected [12].
• Pneumothorax: This condition involved the presence of air in the pleural cavity, and it was often considered alongside pneumopericardium in the differential diagnosis.
• Pneumomediastinum: This condition involved the presence of air in the mediastinal space, and it was also considered in the differential diagnosis of pneumopericardium.

It's worth noting that pneumopericardium is a rare condition, and its incidence has decreased over time due to advances in medical technology and treatment. However, it remains an important consideration in the differential diagnosis of chest pain and other conditions that affect the pericardial space.

References:

[1] RW Emery (1984) - Pneumopericardium: A complication of ventilatory management of neonatal respiratory distress syndrome. [2] YK Park (2014) - Pneumopericardium in adults: A review of the literature. [3] S Roychoudhury (2017) - Neonatal pneumopericardium: A rare but serious condition. [10] Background. The pericardial cavity in this image is labeled d and is part of the inferior mediastium. [12] Pneumopericardium, an accumulation of air in the pericardial cavity, occurs very rarely as compared to pneumothorax and pneumomediastinum. [13] Keywords: Pneumopericardium, Pericardiocentesis. Introduction. Pneumopericardium is defined as the presence of air-fluid level in the pericardial sac and has been reported to result from a spontaneous or iatrogenic cause of underlying disease.