Diastolic compression of the right atrium and right ventricle as an echocardiographic sign of pericardial tamponade. Case report

A 33 years old female patient requiring regular hemodialysis for chronic renal failure exhibited a severe hypotensive episode. 2-dimensional echocardiography enabled rapid recognition of the underlying cause. 2-dimensional echocardiography revealed a large pericardial effusion and from the apical window a marked diastolic compression of the right atrium and the right ventricle was noted. These findings have been previously described to be specific for cardiac tamponade. After removal of 400 ml of fluid by pericardiocentesis the clinical symptoms rapidly improved and in the 2-dimensional echocardiography diastolic compression of the right sided heart chambers was not longer evident, although a substantial amount of pericardial fluid was still present. This case report underlines the clinical usefulness of 2-dimensional echocardiography for the diagnosis of cardiac tamponade.     

Primary liposarcoma of the right atrium

Primary intracardiac liposarcomas are among the rarest tumors of the heart, with a total of six reported cases. The previous reports have focused on clinical features with minimal histologic documentation. We report a primary right atrial liposarcoma showing extracardiac spread and three types of histologic differentiation. This case demonstrated that certain clinical and pathologic features are common to all intracavitary cardiac neoplasms, emphasizing the need for careful histologic examination.     

Survival of hydatid cysts after puncturing.

The release of antigens from hydatid cysts, essential for the induction of a detectable host antibody response, is considered to depend on alterations in the physical integrity of the cyst germinal membrane. This explanation, however, does not account for the detection of serologic responses in persons harbouring hyaline cysts unless it were possible for membrane microfissures to arise and provide an antigenic stimulus without adversely affecting cyst viability. The results of the present study have demonstrated that hydatid cysts are able to survive when experimentally punctured in vitro or in vivo. These findings on the capacity of hyaline cysts to repair or recuperate from a microfissure are consistent with the detection of antibody responses in persons harbouring hyaline hydatid cysts with apparently intact membranes and with the hypothesis of an association between integrity of cyst membranes and degree of host immunological responses.     

Familial colloid cysts of the third ventricle

A father and daughter with colloid cysts of the third ventricle are described. The nine previously reported examples of familial occurrence are reviewed, and the conclusion is reached that inheritance is likely autosomal dominant. The proportion of all cases which are genetic is not known. A plea is made for routine detailed and thorough family histories on all patients with such cysts and a high index of suspicion for non-specific symptoms in relatives such as headaches, migraine, depression, anxiety, nausea and vomiting.     

Hemangioma of the right atrium: imaging and pathology

BackgroundCardiac hemangiomas are benign neoplasms which have been reported to appear as well-circumscribed, homogenous, enhancing masses at imaging.Methods and resultsWe report a 49-year-old woman with a cardiac hemangioma detected by echocardiography, computed tomography, and magnetic resonance imaging. The multiple imaging modalities showed features which have been reported in cardiac hemangiomas. The tumor was surgically excised and the diagnosis of cardiac hemangioma was made.ConclusionsCardiac hemangiomas are rare tumors with a variety of imaging features which may suggest the diagnosis.     

Chiari anomalies in the human right atrium

Chiari anomalies in the human right atrium ostensibly are encountered rarely. There is only sporadic mention in the literature of these fenestrated, net-like valves of the inferior vena cava, coronary sinus, or various strands connecting these with other right atrial structures. The effects of such structural anomalies on heart function are unknown. We report here gross observations of the right atrial net from among 213 cadavers, 38 autopsied, and 11 fetal hearts. Histological and ultrastructural examination of inferior vena cava and coronary sinus valves demonstrated that only the anomalous coronary sinus valves contained cardiac muscle. Chiari anomalies typically have referred to perforations or tissue strands related to the inferior vena cava valve and possibly the coronary sinus valve. The anomaly commonly is cited as occurring in 2% of individuals, although there has been no study to support this. We observed Chiari malformations in 13.6% of the 213 cadaver hearts, and 10.5% of the autopsied hearts examined. Of these malformations, the coronary sinus valve was fenestrated most frequently. We propose the term "right atrial net" for "Chiari net," for anomalies involving valves of the inferior vena cava and coronary sinus, and strands within the right atrium connecting these valves with the crista terminalis, right atrial wall, or interatrial septum.     

Penetration of host IgG molecules into hydatid cysts

Summary Host IgG was detected in 15 out of 18 peritoneal hydatid cysts obtained from experimentally infected gerbils and in 18 out of 61 mouse hydatid cysts which had been implanted into the peritoneal cavity of gerbils for periods ranging from one day to two years. A wide variation in host IgG concentration was observed among the different cysts in which these immunoglobulins were found.These findings are discussed in terms of the possible manner by which macromolecules may enter into the hydatid cysts.     

Trial therapy of inoperable abdominal hydatid cysts by puncture

Hydatidosis is a major public health problem in Tunisia. The infection rate in the normal population is over a 100 times higher than in the generally accepted hyperendemicity level (1,720 in 100,000 as against 13 in 100,000!). The use of drugs of benzimidazole derivates prevents the development of scolices into hydatic cysts and allows to try a non-surgical cure by the punction of hydatid cyst of the sheep liver, i.e. aspiration of the cyst fluid and injection of hypertonic salt solution into the drug treated animal. The good results obtained in a group of 16 animals permitted us to apply this method to two patients whose conditions made surgical intervention dangerous. The results although excellent in the case of a secondary peritoneal cyst were less spectacular in the case of secondary liver cyst of whose wall showed signs of involution.