Derrame pericárdico canino : revisão da literatura e descrição de quatro casos clínicos
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2022
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O derrame pericárdico (DP) é a afeção pericárdica mais comum em cães, consistindo
na acumulação excessiva de líquido no espaço pericárdico, predominando os derrames
sanguinolentos de origem neoplásica ou idiopática. O DP de etiologia neoplásica está
associado a um mau prognóstico, apresentando-se o hemangiossarcoma como o mais
comum. O abafamento dos sons cardíacos, a distensão jugular e o pulso femoral fraco ou
paradoxal, constituem os sinais clínicos característicos. Em caso de tamponamento e
consequente instabilidade hemodinâmica, a pericardiocentese é o procedimento instituído
para a sua resolução. Não obstante, após recidivas de derrame pericárdico a pericardiectomia
deve ser considerada, afirmando-se como o tratamento paliativo de eleição.
Esta dissertação apresenta quatro casos clínicos cujo diagnóstico e tratamento foram
preconizados no Hospital Veterinário do Atlântico. A informação obtida dos casos clínicos, foi
analisada, comparada entre si e com a bibliografia referente a doença pericárdica. Dos casos
clínicos descritos só em dois deles houve um diagnostico definitivo, que incluía:
Quemodectoma, e hemangiossarcoma do átrio direito com pericardite fibrosa crónica. A
ecocardiografia foi o meio não invasivo mais útil no diagnóstico de tamponamento cardíaco.
Paralelamente, a pericardiectomia sub-total e a obtenção de amostras durante o procedimento
cirúrgico foram fundamentais para estabelecer um diagnóstico etiológico definitivo.
Pericardial effusion (DP) is the most common pericardial disease in dogs, that includes an excessive accumulation of fluid in the pericardial space. In this species, bloody effusion of neoplastic origin or idiopathic origin predominate. A neoplastic pericardial effusion is normally associated to a bad prognosis and the hemangiosarcoma is the most common. The muffling of heart sounds, jugular distension and weak or paradoxical femoral pulse, are the main clinical signs of pericardial effusion. In case of tamponade and consequent haemodynamic instability, pericardiocentesis is the initial procedure instituted for its resolution. Nevertheless, after recurrences of DP following one or more pericardiocenteses, pericardiectomy should be considered, affirming itself as the palliative treatment of choice. This dissertation ends with the presentation of four clinical cases whose diagnosis and surgical treatment by sub-total pericardiectomy were recommended at the Hospital Veterinário do Atlântico. The information obtained through the cases’ anamnesis was analysed and compared with one another and with the literature on pericardial disease. An effective diagnosis was only achieve in two out of four of the clinical described cases. The diagnosis included: Echocardiography was the most useful non-invasive exam for diagnosing cardiac tamponade. In parallel sub-total pericardiectomy with samples for histopathology were fundamental to establish a definitive etiological diagnosis.
Pericardial effusion (DP) is the most common pericardial disease in dogs, that includes an excessive accumulation of fluid in the pericardial space. In this species, bloody effusion of neoplastic origin or idiopathic origin predominate. A neoplastic pericardial effusion is normally associated to a bad prognosis and the hemangiosarcoma is the most common. The muffling of heart sounds, jugular distension and weak or paradoxical femoral pulse, are the main clinical signs of pericardial effusion. In case of tamponade and consequent haemodynamic instability, pericardiocentesis is the initial procedure instituted for its resolution. Nevertheless, after recurrences of DP following one or more pericardiocenteses, pericardiectomy should be considered, affirming itself as the palliative treatment of choice. This dissertation ends with the presentation of four clinical cases whose diagnosis and surgical treatment by sub-total pericardiectomy were recommended at the Hospital Veterinário do Atlântico. The information obtained through the cases’ anamnesis was analysed and compared with one another and with the literature on pericardial disease. An effective diagnosis was only achieve in two out of four of the clinical described cases. The diagnosis included: Echocardiography was the most useful non-invasive exam for diagnosing cardiac tamponade. In parallel sub-total pericardiectomy with samples for histopathology were fundamental to establish a definitive etiological diagnosis.
Descrição
Orientação: Maria João Soares
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, CÃES, DERRAME PERICÁRDICO, PERICARDIOCENTESE, VETERINARY MEDICINE, DOGS, PERICARDIAL EFFUSION, PERICARDIOCENTESIS