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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of cardiac tamponade showing the characteristic flow pattern in the superior vena cava is reported. An 80-year-old man was admitted to our hospital complaining of anorexia and general fatigue. We observed a paradoxical pulse of 25 mmHg, dilatation of the jugular vein, and marked cardiomegaly on chest radiography. A two-dimensional echocardiogram demonstrated a massive pericardial effusion and collapse of the right atrial and right ventricular walls. On the basis of his echocardiograms and clinical signs, we diagnosed his condition as cardiac tamponade. Pulsed Doppler echocardiograms showed two-peaked flow in the superior vena cava in systole. To assess the diagnostic significance of this characteristic flow pattern, the superior vena cava flow was recorded simultaneously with the intrapericardial pressure and the right atrial pressure. The intrapericardial pressure was higher than the right atrial pressure in early systole. After pericardial drainage, these pressures became reversed and the two-peaked flow disappeared. The two-peaked flow is attributed to collapse of the right atrial wall caused by the higher intrapericardial pressure than the right atrial pressure. The superior vena cava flow represents the right heart filling dynamics in cardiac tamponade.
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PMID:[The characteristic flow of the superior vena cava in cardiac tamponade: a case report]. 816 29

We report on a 44-year-old male with primary cardiac angiosarcoma who died 11 months after onset of nonspecific symptoms (thoracic pain and general fatigue) of intracerebral metastases. A right atrial tumor mass and a pericardial effusion could be demonstrated by transthoracic and transesophageal echocardiography. Cardiac angiography showed a right atrial hemangioma, fed by the right coronary artery. In a review of 108 cases of primary cardiac angiosarcoma we summarize clinical features, diagnostic means, therapeutic approaches and life expectancy of this rare disease.
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PMID:Primary angiosarcoma of the heart. Report of a case and review of the literature. 830 53

High cardiac output failure/state (HCOF) is regular feature of some illnesses e.g. thiamine deficiency, hyperthyroidism, severe anemia, Paget's disease or arteriovenous fistulae. HCOF in multiple myeloma is reported quite rarely. 31-year-old man was admitted because of fatigue, dyspnea and subfebrilities. Heart rate was 116/min, sinus rythm blood pressure 110/60 mmHg. Chest film showed cardiomegaly with sings of interstitial pulmonary edema, echocardiography mild dilatation of the left ventricle with hyperkinetic wall motion and small pericardial effusion. Hemoglobin was 104 g/l, leukocyte count 13.5 x 10(9)/l with 30% of plasmatic cells. Serum protein electrophoresis demonstrated a monoclonal gammapathy, X ray studies of the skelet multiple osteolytic lesions. Diagnosis of plasmocytic leukemia-form of multiple myeloma was established and chemotherapy (vincristine + adriamycine + dexamethason) was started. Patient cardiac status deteriorated. Cardiac catheterisation demonstrated mean righ atrial pressure of 25 mmHg, mean pulmonary artery pressure of 28 mmHg and pulmonary artery wedge pressure of 24 mmHg. Co was 20.0 l/min (C.I. 11.5 l/min/m2). In continuing of chemotherapy and symptomatic therapy for heart failure patients status gradually improved and complete remission of the myeloma and normalisation of cardiac parameters was achieved. Heart failure in multiple myeloma patients has been attributed to amyloidosis of myocardium, hyperviscosity syndrome, co-existing CAD or anthracycline toxicity. HCOF should be considered in patients with clinical evidence of heart failure and normal left ventricular function.
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PMID:[Hypercirculatory heart failure in a patient with plasmacytic leukemia]. 855 97

Localized pericardial effusion leading to cardiac tamponade is seen occasionally in patients after cardiac surgery. This condition may be difficult to diagnose clinically because of unusual presenting symptoms and absence of conventional signs of cardiac tamponade. A case of localized pericardial effusion with presenting symptoms of fever and increasing fatigue is described in this study. The definitive diagnosis was made using transesophageal echocardiography. Surgical drainage of localized effusion resulted in prompt hemodynamic and symptomatic improvement.
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PMID:Unusual presentation of late regional cardiac tamponade after aortic surgery. 891 10

A 69-year-old woman was admitted to the hospital because of coughing, dyspnea, generalized fatigue, and pretibial edema. A chest X-ray film revealed cardiac enlargement, a left hilar mass, and a small nodule in the right middle lung field. Echocardiography showed a massive pericardial effusion. A chest CT scan showed pericardial effusion, an anterior mediastinal mass, and a small nodule in the right upper lobe. Examination of a percutaneous biopsy specimen showed round and spindle-shaped tumor cells and lymphocyte infiltration, which was consistent with mixed-cell-type thymoma. Hematological examination showed macrocytic anemia, and the concentration of vitamin B12 was 65 pg/ml (249-938 pg/ml). A test for anti-parietal cell antibodies was positive. Our diagnosis was pernicious anemia and stage IVb invasive thymoma (by Masaoka's classification). Because of the intrapulmonary metastasis and pericardial effusion, the patient underwent chemotherapy. The tumor shrank, so a thoracotomy was done. However, the tumor was found to have invaded the heart and large vessels, and it could not be removed. After surgery the thorax was irradiated. Invasive thymoma complicated by pernicious anemia is rare.
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PMID:[Invasive thymoma in patient with pernicious anemia and pericardial effusion]. 929 2

A 47-year-old woman was admitted to our hospital for evaluation of general fatigue and dyspnea. She had been diagnosed with progressive systemic sclerosis (PSS) when she was 39 years of age, on the basis of Raynaud's phenomenon, proximal sclerosis, and pigmentation of the skin. On admission, her blood pressure was 206/128 mmHg. Funduscopy revealed grade III (Keith & Wagener) hypertensive retinopathy. Laboratory data showed positivity for anti-nuclear antibody and anticardiolipin beta 2 glycoprotein I antibody, and the plasma level of renin activity (PRA) was abnormally high. Chest X-ray and UCG revealed massive pericardial effusion. On the second hospital day, she was operated on for pericardiodiaphragmatic fenestration. The volume of pericardial effusion amounted to more than 2000 ml. Post operative malignant hypertension persisted. Laboratory data showed thrombocytopenia, hemolytic anemia, and acute renal failure. We diagnosed scleroderma renal crisis (SRC) associated with antiphospholipid syndrome. Following the initiation of angiotensin converting enzyme inhibitor (ACE-I) combined with calcium antagonist and alpha-one blocker, her blood pressure and PRA decreased. She also had been treated with aspirin 81 mg daily. These therapies were effective in recovering the platelet count and stopped the progression of anemia and renal failure. Although either the finding of large pericardial effusion or SRC is associated with poor prognosis in PSS, this case has had a good clinical course. In this case, the findings suggested that anti-phospholipid antibody may have contributed to the pericarditis and SRC.
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PMID:[A case of scleroderma renal crisis with massive pericardial effusion and positivity on antiphospholipid antibody test]. 965 14

We successfully treated a case of active infective endocarditis in the remission phase of virus-associated hemophagocytic syndrome (VAHS). A 21-year-old man was admitted to our hospital for fever, arthralgia, and general fatigue. His blood cultures revealed staphylococcus epidermidis. He underwent urgent aortic valve replacement and closure of the abscess cavity because of an ineffective antibiotic therapy and a progressive left heart failure. Operative findings showed about 100 ml bloody pericardial effusion, fresh vegetation on the aortic left coronary and non-coronary leaflets, and aortic root abscess just below the left coronary ostium. The aortic root abscess extended to the left ventricular wall between the base of left atrial appendage and the base of main pulmonary artery and was in the state of impending rupture. The left main coronary artery was fully exposed after debridement in the abscess cavity. It was thought that left atrial appendage as a pedicle was useful for filling up the abscess cavity to protect infection.
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PMID:[A case of active infective endocarditis in the remission phase of virus-associated hemophagocytic syndrome]. 972 Mar 81

Ebstein's anomaly is a malformation of the tricuspid valve characterized from the clinical view point by dysnea, evolutive cyanosis and fatigue. Is it characterized anatomically by a downward displacement of the tricuspid valve into the right ventricle due to anomalous attachment of the tricuspid leaflets. Because of the abnormally situated tricuspid orifice, a portion of the right ventricle lies between the atrioventricular ring and the origin of the valve, that is, an "atrialized" segment of the ventricle, and they have a functionally small ventricular chamber. Roentgenographic studies, usually demonstrate a characteristic enlarged heart. The globular-shaped heart on a chest X-ray may closely resemble the picture usually associated with a large pericardial effusion. The ecocardiographic study is more specific for the differential diagnosis, and usually eliminates one pathology but confirms the other. The patient that we are presenting is unusual, and, as far as we know, it is the only in the literature case in which there is a coexistence of the important pericardial effusion and the Ebstein's anomaly. We review the functional abnormalities of the right ventricle with Doppler and two-dimensional echocardiography in this patient.
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PMID:[Ebstein's anomaly related with significant pericardial effusion. Report and analysis of a case]. 978 92

A 40-year-old woman who had been treated for Takayasu's arteritis was admitted to the hospital with fever, fatigue, malaise, and severe chest pain. Computed tomography of the chest demonstrated massive pericardial effusion and bilateral pleural effusion. In laboratory data, the C-reactive protein was high at 22.0 mg/dL, and erythrocyte sedimentation rate was also high at 80 mm/hr. The diagnosis was pericarditis with a recurrence of the systemic inflammatory process of Takayasu's arteritis. The patient was treated with methylprednisolone pulse therapy. Her massive pericardial effusion disappeared without pericardiocentesis.
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PMID:Takayasu's arteritis accompanied with massive pericardial effusion--a case report. 1034 31

A 22-year-old woman underwent surgical repair of a secondary atrial septal defect. Thirty-five days after surgery, she developed fever, systemic venous congestion, and respiratory symptoms and chest pain. The echocardiogram demonstrated pericardial effusion (PE) quantified at approximately 3,500 cc, with signs of cardiac tamponade (CT). Pericardiocentesis was performed and symptomatology subsides when Prednisone 10 mg was administered every 24 h. Fourteen days after discharge, she was readmitted due to progressive dyspnea, orthopnea and fatigue. The echocardiogram showed the reappearance of PE and a mild CT. Prednisone 40 mg/day was given. After 10 days an echocardiogram showed are duction of the PE (600 cc) and the clinical condition of the patient improved. Three months later, PE disappeared in the echocardiogram and the patient remained asymptomatic.
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PMID:[Recurrent cardiac tamponade secondary to postpericardiotomy syndrome]. 1060 59


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