The case of the vanishing pneumopericardium‼️ скачать в хорошем качестве

The case of the vanishing pneumopericardium‼️

A pneumopericardium is the presence of air or gas within the pericardial sac, which is the thin, double-walled membrane surrounding the heart. It is a rare but potentially serious condition, especially in neonates and trauma patients. ⸻ 🫁 Causes of Pneumopericardium • Neonatal causes: • Mechanical ventilation, particularly with high pressures (e.g., in preterm infants) • Alveolar rupture leading to air tracking into the pericardium • Resuscitation with positive-pressure ventilation • Associated air leak syndromes: pneumothorax, pneumomediastinum • Other causes: • Blunt or penetrating chest trauma • Infections producing gas (rare) • Surgical or procedural complications (e.g., during cardiac surgery or central line placement) ⸻ 🔬 Clinical Features • Tachycardia, hypotension • Muffled heart sounds • Distended neck veins (if tamponade physiology occurs) • “Mill wheel” murmur – a splashing cardiac sound in some cases • In neonates: cyanosis, poor perfusion, or sudden cardiovascular collapse ⸻ 📷 Diagnosis • Chest X-ray: • Air outlining the heart, often with a halo sign or continuous lucency around the heart border • Echocardiogram: Can show air around the heart and help rule out tamponade • CT chest: More detailed but rarely required in neonates ⸻ ⚠️ Complications • Cardiac tamponade: Compression of the heart by air can impede filling and cause hemodynamic instability • Progression to pneumomediastinum or tension pneumopericardium ⸻ 🩺 Management • Supportive care: Oxygen, minimizing ventilator pressures • Pericardiocentesis: If signs of tamponade or cardiovascular compromise • Treat underlying cause: Adjust ventilator settings, treat trauma or infection Source: https://pubmed.ncbi.nlm.nih.gov/40704...