A Rare Pericardial Malignancy
| Autor: | Dennis J. Firchau, Urooj Fatima, Alan H. Stolpen, Sarika Gupta, Rajan Sah |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Mesothelioma Orthopnea Respiratory rate Sinus tachycardia Computed Tomography Angiography Biopsy Cardiovascular examination 030204 cardiovascular system & hematology Chest pain Diagnosis Differential Heart Neoplasms 03 medical and health sciences Electrocardiography 0302 clinical medicine Medicine Humans Heart Failure medicine.diagnostic_test business.industry Thoracic Surgery Video-Assisted Stroke Volume Middle Aged medicine.disease Magnetic Resonance Imaging 030220 oncology & carcinogenesis Anesthesia medicine.symptom Cardiology and Cardiovascular Medicine business Right axis deviation Chest radiograph Pericardium Paroxysmal Nocturnal Dyspnea |
| Zdroj: | Circulation. Heart failure. 9(7) |
| ISSN: | 1941-3297 |
| Popis: | A 60-year-old man without significant past medical history presented with 1 month of gradually increasing dyspnea on exertion, associated with generalized fatigue and pedal edema. He denied orthopnea, paroxysmal nocturnal dyspnea, chest pain, fever, cough, or weight loss. One month before this presentation, he could walk for miles and ride a road bike without difficulty. His social history was notable for 45 pack-year smoking and intravenous drug abuse. He worked as a refuse collector and roof mechanic for 2 to 3 years. Vital signs on presentation revealed a blood pressure 97/72 mm Hg, pulse 112 beats per minute, temperature 36.9°C, and respiratory rate of 24 breaths per minute. The oxygen saturation was 98% on room air. Cardiovascular examination revealed mild jugular venous distention to 10 cm, distant heart sounds with no murmurs, an impalpable apical impulse, and 2+ bilateral lower extremity edema. Pulmonary examination was unremarkable with clear breath sounds on auscultation bilaterally. Abdominal and neurological examination was unremarkable. Laboratory testing revealed negative troponins and mildly positive D-Dimer at 0.93 μg/mL. Although N-terminal pro b-type natriuretic peptide was elevated at 1382 pg/mL, a 2-view chest radiograph showed normal cardio-mediastinal silhouette and pulmonary vasculature. An ECG on admission showed sinus tachycardia with a rate of 110 beats per minute, right axis deviation, low-voltage complexes, and T wave inversions in leads V4, V5, and V6. Based on examination findings and initial testing, a computed tomographic … |
| Databáze: | OpenAIRE |
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