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Image in Cardiology
Pneumopericardium and squamous cell lung carcinoma
Pneumopericárdio e carcinoma epidermóide do pulmão
Carla Marques Piresa,
Autor para correspondência
carlammpr@gmail.com

Corresponding author.
, Leonor Meirab
a Department of Cardiology, Braga Hospital, Braga, Portugal
b Department of Pneumology, Braga Hospital, Braga, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 53-year-old man&#44; a former smoker with squamous cell lung carcinoma under palliative chemotherapy as relevant prior history&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was admitted to the emergency department with sudden worsening of rest dyspnea and pleuritic chest pain&#46; He was hemodynamically stable and had decreased breath sounds in the left lung&#46; The electrocardiogram showed a widespread concave ST-elevation and PR-depression and reciprocal ST-depression and PR-elevation in lead aVR&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The transthoracic echocardiogram revealed normal biventricular function&#44; no kinetic segmental changes&#44; &#8220;swirling bubbles sign&#8221; in the pericardial sac and &#8220;air gap sign&#8221; &#40;<a class="elsevierStyleCrossRef" href="#sec0015">video 1</a>&#41;&#44; manifesting in the disappearance of the cardiac silhouette in systole&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The chest radiography showed signs of pneumopericardium &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; long yellow arrows&#41; and left cavitary lung mass&#46; For better characterization&#44; the patient underwent a computed tomography lung scan which revealed the extension &#40;from the apex to the diaphragmatic surface&#41; of the thick-walled gas-filled mass &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#47;B&#44; short black arrow&#41; with an air-fluid level &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>B&#44; long black arrow&#41; and distension of pericardial cavity with air-fluid level &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>A&#47;B&#44; long yellow arrow<span class="elsevierStyleItalic">&#41;</span> due to a direct pleuro-pericardial communication&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Due to hemodynamical stability&#44; with no clinical or echocardiographic signs of tension pneumopericardium&#44; the patient was monitored and managed conservatively under watchful observation&#46; Unfortunately&#44; the patient&#39;s condition deteriorated progressively&#44; and he died 18 days later&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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