Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency

Background. Chylopericardium is the accumulation of lymphatic fluid in the pericardial cavity. It can be idiopathic or secondary to trauma, cardiothoracic surgery, neoplasm, radiation, tuberculosis, lymphatic duct dysfunction, thrombosis, or other causes. We present a case of chylopericardium due to...

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Main Authors: Ian Jackson, Yaman Alali, Abedel Rahman Anani, Ali Nayfeh, Arindam Sharma, Abhishek Thandra, Amjad Kabach
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2021/2232057
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author Ian Jackson
Yaman Alali
Abedel Rahman Anani
Ali Nayfeh
Arindam Sharma
Abhishek Thandra
Amjad Kabach
author_facet Ian Jackson
Yaman Alali
Abedel Rahman Anani
Ali Nayfeh
Arindam Sharma
Abhishek Thandra
Amjad Kabach
author_sort Ian Jackson
collection DOAJ
description Background. Chylopericardium is the accumulation of lymphatic fluid in the pericardial cavity. It can be idiopathic or secondary to trauma, cardiothoracic surgery, neoplasm, radiation, tuberculosis, lymphatic duct dysfunction, thrombosis, or other causes. We present a case of chylopericardium due to subclavian vein thrombosis in a patient with protein S deficiency. Clinical Case. A 48-year-old man with a history of protein S deficiency presented to the emergency department with shortness of breath and a productive cough. CT of the chest showed pulmonary emboli, moderate pericardial effusion, and a large thrombus of the superior vena cava, brachiocephalic vein, and subclavian veins. He developed echocardiographic evidence of cardiac tamponade so he underwent pericardiocentesis with drainage of milky-appearing fluid. Analysis of the fluid showed elevated triglycerides consistent with chylopericardium. The pericardial effusion reaccumulated, likely secondary to lymphatic duct obstruction due to his subclavian vein thrombus. Catheter-assisted thrombolysis was performed with resolution of the patient’s effusion and symptoms. Conclusion. Chylopericardium is a rare but important complication of subclavian vein thrombosis. Management is typically with surgical intervention, although our case represents successful treatment with catheter-assisted thrombolysis.
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spelling doaj-art-d1744ee5b5054b5fbc6611c3c11f3cfd2025-02-03T05:53:26ZengWileyCase Reports in Cardiology2090-64122021-01-01202110.1155/2021/2232057Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S DeficiencyIan Jackson0Yaman Alali1Abedel Rahman Anani2Ali Nayfeh3Arindam Sharma4Abhishek Thandra5Amjad Kabach6Department of MedicineDepartment of MedicineDepartment of MedicineDepartment of Pulmonary and Critical CareDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyBackground. Chylopericardium is the accumulation of lymphatic fluid in the pericardial cavity. It can be idiopathic or secondary to trauma, cardiothoracic surgery, neoplasm, radiation, tuberculosis, lymphatic duct dysfunction, thrombosis, or other causes. We present a case of chylopericardium due to subclavian vein thrombosis in a patient with protein S deficiency. Clinical Case. A 48-year-old man with a history of protein S deficiency presented to the emergency department with shortness of breath and a productive cough. CT of the chest showed pulmonary emboli, moderate pericardial effusion, and a large thrombus of the superior vena cava, brachiocephalic vein, and subclavian veins. He developed echocardiographic evidence of cardiac tamponade so he underwent pericardiocentesis with drainage of milky-appearing fluid. Analysis of the fluid showed elevated triglycerides consistent with chylopericardium. The pericardial effusion reaccumulated, likely secondary to lymphatic duct obstruction due to his subclavian vein thrombus. Catheter-assisted thrombolysis was performed with resolution of the patient’s effusion and symptoms. Conclusion. Chylopericardium is a rare but important complication of subclavian vein thrombosis. Management is typically with surgical intervention, although our case represents successful treatment with catheter-assisted thrombolysis.http://dx.doi.org/10.1155/2021/2232057
spellingShingle Ian Jackson
Yaman Alali
Abedel Rahman Anani
Ali Nayfeh
Arindam Sharma
Abhishek Thandra
Amjad Kabach
Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency
Case Reports in Cardiology
title Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency
title_full Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency
title_fullStr Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency
title_full_unstemmed Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency
title_short Chylopericardium due to Subclavian Vein Thrombosis in the Setting of Protein S Deficiency
title_sort chylopericardium due to subclavian vein thrombosis in the setting of protein s deficiency
url http://dx.doi.org/10.1155/2021/2232057
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