Estatísticas

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    "titulo" => "The heart in an air bubble"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray on admission showing a radiolucent band of air partially surrounding the heart &#40;arrows&#41; consistent with pneumopericardium&#44; in posteroanterior &#40;A&#41; and lateral &#40;B&#41; views&#59; chest computed tomography scan confirming the presence of pneumopericardium &#40;arrows&#41;&#44; in coronal &#40;C&#41; and axial &#40;D&#41; views&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 50-year-old man presented to the emergency department with three-day progressive worsening of dyspnea&#46; His medical history included poorly differentiated stage IV epidermoid lung carcinoma&#44; under palliative chemotherapy&#46; On admission&#44; he was hemodynamically stable&#44; with no signs of respiratory distress&#46; There were no significant abnormalities on laboratory or blood gas analysis&#46; The chest X-ray &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A and B&#41; showed a radiolucent band of air partially surrounding the heart&#46; Thoracic computed tomography &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C and D&#41; confirmed the presence of pneumopericardium&#46; Air in the pericardial space made acquisition of transthoracic echocardiographic images impossible &#40;no echocardiographic window&#41;&#46; The patient did not present clinical manifestations of cardiac tamponade&#44; so conservative treatment was decided on&#46; He improved clinically and was safely discharged to the outpatient palliative care clinic after one week&#46; At one-month follow-up&#44; the patient was asymptomatic with no evidence of residual pneumopericardium on the chest X-ray&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Pneumopericardium in patients with lung cancer is extremely rare&#46; It is thought to be caused by formation of a bronchopericardial fistula by direct pericardial invasion of the tumoral mass &#40;the most likely cause of pneumopericardium in our patient&#41;&#44; or iatrogenic trauma due to invasive procedures&#44; or rupture of a bulla into the pericardium through a necrotic focus&#46; In stable patients&#44; pneumopericardium can be treated conservatively&#44; although close clinical monitoring is advised&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">This case report shows a rare but potentially life-threatening condition&#44; diagnosed in the emergency department with a chest X-ray&#44; which highlights the value in clinical practice of recognizing classic images in simple&#44; inexpensive and readily available exams&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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