Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Pericarditis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources
PubMed2001

Successful use of thoracoscopic pericardiectomy in elderly patients with massive pericardial effusion caused by uremic pericarditis.

We report the use of thoracoscopic pericardiectomy to treat two elderly patients with massive pericardial effusion caused by uremic pericarditis. A 79-year-old man, admitted to our hospital complaining of dyspnea, was diagnosed with end-stage renal failure and began maintenance hemodialysis. Although intensive hemodialysis was performed, the patient could not remain on hemodialysis because of severe hypotension during the procedure. Echocardiography revealed massive pericardial effusion and severe hypokinesis of the left ventricular wall. Pericardiocentesis was performed first, without success, followed by thoracoscopic pericardiectomy under general anesthesia. One month after the pericardiectomy, episodes of hypotension during hemodialysis improved, and dyspnea diminished. Echocardiography showed no pericardial effusion and improvement of left ventricular wall motion. Pericarditis is a fatal complication in patients with end-stage renal failure and patients on maintenance hemodialysis. The second patient received the same procedure with a similar improvement of clinical symptoms. These cases suggest that thoracoscopic pericardiectomy is a safe and effective treatment of pericardial effusion caused by uremic pericarditis in elderly patients on hemodialysis.

Aged↗
PubMed2002

Purulent pneumococcal pericarditis: a rarity in the antibiotic era.

PURPOSE: The purpose of this report is to show that even while properly treated, pneumococcal disease may proceed to a life-threatening condition including purulent pericarditis and multiple organ failure. PATIENTS AND METHODS: This is a case-report describing one patient treated in the intensive care unit (ICU) of Helsinki University Central Hospital in March 2001. CONCLUSIONS: In the antibiotic era, purulent pericarditis is an extremely rare yet possible condition complicating pneumococcal disease. Because of the growing incidence of penicillin resistance of this community-acquired pathogen, purulent pericarditis may become more common. Early detection and treatment of this otherwise fatal condition may lead to a good outcome.

Anti-Bacterial Agents↗
PubMed2002

Pseudomonas pericarditis in an immunocompetent newborn: unusual presentation with review of the literature.

Acute purulent pericarditis is a rare entity in the neonatal age group. The most common isolated organisms are Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae. Other organisms, like Pseudomonas aeruginosa, have been seldom implicated with only one case of Pseudomonas pericarditis reported in the neonatal period. The prognosis is often considered very poor in this age group. This article describes Pseudomonas pericarditis in a 1-week-old immunocompetent female newborn who was successfully managed with combined medical and surgical therapy.

Anti-Bacterial Agents↗
PubMed2002

Purulent pericarditis in childhood: ten years of experience.

BACKGROUND/PURPOSE: Purulent pericarditis is a rapidly fatal disease if left untreated. This article describes our experience with diagnosis and management of 18 patients seen over a 10-year period. METHODS: Eighteen children with purulent pericarditis were treated in our clinics between 1990 and 2000. Ten patients were boys and 8 were girls, and the mean age of all patients was 4 years (range, 8 months to 12 years). RESULTS: Most common findings were fever and cardiac tamponade. Staphylococcus aureus was the most common causative agent, and the most common predisposing factor was respiratory tract infection. Chest radiography and echocardiography were the most important methods for diagnosis, and pericardiosynthesis was diagnostic in purulent pericarditis. The treatment methods performed in our patients were subxiphoidal pericardial tube (10 patients), pericardiectomy after subxiphoidal pericardial tube (2 patients), pericardiectomy (3 patients), and pericardiocentesis-intrapericardial thrombolytic treatment (3 patients). Only one patient (5.5%) died who was critically ill at the time of admission. CONCLUSIONS: Subxiphoidal tube drainage and pericardiectomy were performed with good results in these cases. Intrapericardial streptokinase and pericardial aspiration method also was thought to be beneficial.

Age Factors↗
PubMed2002

Usefulness of the transgastric view by transesophageal echocardiography in evaluating thickened pericardium in patients with constrictive pericarditis.

Detection of thickened pericardium in patients with constrictive pericarditis is essential for pericardiectomy because restrictive cardiomyopathy and severe tricuspid regurgitation show similar hemodynamic data. The purpose of this study was to clarify whether transesophageal echocardiography can evaluate thickened pericardium. We investigated 7 patients with constrictive pericarditis who underwent pericardiectomy. Thickened pericardium over the right atrium was detected in 6 patients, but the borders were not clear. Thickened pericardium over the left ventricle was not detected in any patients in the standard longitudinal and horizontal views. On the other hand, thickened pericardium over the ventricles was detected in all patients in the transgastric view as an echogenic area between the liver and ventricular wall. Tissue characteristics of the thickened pericardium could be evaluated because of the high-quality images in the transgastric view. The transgastric view by transesophageal echocardiography allows high-quality images of the pericardium, which might be useful in diagnosing constrictive pericarditis.

Diagnosis, Differential↗
PubMed1987

A review of pericarditis. 1. Causes, manifestations, and diagnostic techniques.

Pericardial disease has many causes, clinical manifestations, and complications. Pericarditis, the most common disease of the pericardium, is classified as acute, subacute, or chronic. Acute pericarditis is characterized by chest pain, dyspnea, and presence of a pericardial friction rub. Patients with chronic pericarditis are generally asymptomatic. Laboratory techniques such as electrocardiography, echocardiography, angiography, radionuclide ventriculography, and computed tomography are useful as primary or adjunctive diagnostic procedures.

Cardiac Tamponade↗
PubMed1992

Pericarditis and myocarditis. Which is benign and which isn't?

Pericarditis and myocarditis are inflammatory diseases that are often initiated by common viruses. Pericarditis rarely causes serious long-term disability, whereas myocarditis may lead to chronic congestive cardiomyopathy and permanent disability. The pathogenesis of both is proposed to be bimodal, with an early stage characterized by viral replication and a later stage by infiltration of lymphocytes and necrosis of cells secondary to an autoimmune process. Treatment of pericarditis is usually symptomatic. Myocarditis requires bed rest and conventional therapy for congestive heart failure. Efficacy of immunosuppressive therapy for myocarditis is currently being tested in an international multi-center clinical trial.

Humans↗
PubMed1998

Colchicine for recurrent pericarditis in children.

The incidence of recurrence of acute pericarditis in children varies from 15% to 30% and is accompanied by a high morbidity. Various treatment modalities have been used with variable success rates and side effects. La Serna et al. (Lancet 1987; 26: 1517) were the first to treat adults with recurrent pericarditis with colchicine, and were followed by other authors. To our knowledge no studies in children have been reported. In this paper, we present three children who suffered from viral or idiopathic recurrent pericarditis, despite multiple courses of non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids. They responded remarkably well to colchicine, which was administered for 6 months with no adverse reactions. They continue to do well 18, 11 and 12 months after cessation of treatment, respectively.

Adolescent↗
PubMed2001

Tuberculous pericarditis: optimal diagnosis and management.

Pericarditis is a rare manifestation of tuberculous disease. The appropriate diagnostic workup and optimal therapeutic management are not well defined. We present 10 new cases of tuberculous pericarditis and review the relevant literature. The specific topics addressed are (1) the importance of tissue for diagnosis, (2) the optimal surgical management, (3) the role of corticosteroids, and (4) the impact of human immunodeficiency virus (HIV) on the management of this disease. The cases and the literature suggest that the optimal management includes an open pericardial window with biopsy, both for diagnosis and to prevent reaccumulation of fluid. Corticosteroids probably offer some benefit in preventing fluid reaccumulation as well. The data are inconclusive regarding whether open drainage or corticosteroid use prevents progression to constrictive pericarditis. No studies have addressed these issues specifically in HIV-positive patients, but the 3 HIV-positive patients in our series had an excellent response to drainage and antituberculous therapy.

AIDS-Related Opportunistic Infections↗
PubMed1999

Coxiella burnetii pericarditis: report of 15 cases and review.

Q fever is characterized by its clinical polymorphism, and pericarditis associated with Q fever has occasionally been described. Herein we report 15 cases of Coxiella burnetii pericarditis, 9 from our data bank and 6 encountered within the past 12 months. Three patients presented with life-threatening tamponade. We compare our cases with the 18 previously reported and with 60 Q fever-matched controls at our center. This study showed that Q fever pericarditis can present as acute as well as chronic disease; we describe relapse after 6 months in association with a serological profile compatible with the chronic form of disease (phase I C. burnetii IgG titer of > or = 800). Discriminant factors among patients and controls are age of > 52 years (adjusted odds ratio [OR], 5.66), the occurrence of general symptoms such as arthralgias or myalgias (adjusted OR, 6.54), and a normal erythrocyte sedimentation rate (adjusted OR, 16.37). No specific symptoms or underlying cardiac predispositions are observed.

Adolescent↗
PubMed1993

Mycoplasmal pericarditis: evidence of invasive disease.

Although the pathogenic mycoplasmas usually infect the respiratory and urogenital tracts, these organisms also can cause disease in remote sites. Such infections are difficult to diagnose because of both the fastidious nature of the mycoplasmas and the failure to consider their presence. Pericarditis is an uncommonly diagnosed and rarely confirmed example of invasive mycoplasmal infection. As part of a prospective study of large pericardial effusions, we discovered two cases with Mycoplasma pneumoniae infection. Subsequently, two cases of pericarditis due to Mycoplasma hominis and one due to Ureaplasma urealyticum were diagnosed. For all five patients, cultures of pericardial tissue and/or fluid were positive. In addition, four of the five patients either were immunocompromised or had undergone cardiac surgery previously. Appropriate antibiotic therapy was uniformly effective. We report here our experience with mycoplasmal pericarditis, provide evidence of an invasive pathogenesis for this syndrome, and suggest that pericardial disease caused by these organisms may not be an uncommon finding when sought in an aggressive manner.

Adult↗
PubMed1994

Mycobacterium kansasii pericarditis in patients with AIDS.

Pericardial effusion has been reported to occur in up to 38% of patients with AIDS. Many different etiologies for pericarditis have been described. In some instances, such infections have caused severe hemodynamic complications and life-threatening conditions. Mycobacterium kansasii is known to cause pulmonary and disseminated infections in immunocompromised patients, including those with AIDS; however, to the best of our knowledge, pericarditis due to an infection with this organism has not been described. We report the first three cases of M. kansasii pericarditis in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Primary meningococcal pericarditis: a disease of adults associated with serogroup C Neisseria meningitidis.

Pericarditis due to Neisseria meningitidis is usually a consequence of meningeal disease or meningococcemia. This presentation includes a case report of primary meningococcal pericarditis (PMP) and a review of the clinical and epidemiologic features of 15 previously reported cases. All cases have been reported in the past 15 years. Most patients were older teenagers or adults. The median age and age distribution of PMP cases in the United States were significantly greater than that of patients with other meningococcal diseases reported to the Centers for Disease Control (CDC) (P = .005). Similarly, serogroup C N. meningitidis was isolated from 88% of U.S. patients with PMP, compared with isolation from 22% of patients with other meningococcal diseases reported to the CDC (P = .00016). Culture of pericardial fluid usually yielded meningococci, and most patients presented with signs and symptoms typical of purulent pericarditis. A positive pericardial culture was associated with the development of cardiac tamponade (P = .03). With appropriate antibiotic treatment and drainage of pericardial fluid when indicated, all 16 patients survived and experienced few or no sequelae.

Adolescent↗
PubMed1995

The diagnostic and prognostic value of adenosine deaminase in tuberculous pericarditis.

Because of the difficulty in isolating the causative organism, pericardial tuberculosis is rarely diagnosed. Adenosine deaminase activity measured in the pericardial fluid of 108 patients was initially of undetermined origin. Subsequently, we classified five sources: (1) tuberculosis (20 cases); (2) idiopathy (82 cases); (3) neoplasia (three cases); (4) purulent bacterial infection (two cases); and (5) radiotherapy (one case). The highest mean adenosine deaminase value (126 +/- 16.68 U.l(-1) was found in group 1; other values were 29.4 +/- 8.9, 27 +/- 7.21, 29.5 +/- 13.4, 26 U.l(-1) in the idiopathy, neoplasia, purulent bacterial infection and radiotherapy groups, respectively. there was a statistically significant difference between group 1 and the other groups (P less than 0.001), indicating that the adenosine deaminase value has 100% sensitivity and 91% specificity. In addition, there was a positive correlation between high adenosine deaminase values and the development of constrictive pericarditis. In this study, two patients required pericardectomy. Therefore, the adenosine deaminase value is a significant prognostic indicator for the development of constrictive pericarditis in tuberculous pericarditis.

Adenosine Deaminase↗
PubMed1988

Maximal spatial ST vector of S-T segment elevation in the right praecordial leads on electrocardiogram due to acute pericarditis.

Three patients with acute pericarditis with S-T segment elevation in the right praecordial leads were studied by vectorcardiography. The vectorcardiographic findings suggested that, in acute pericarditis, the maximal spatial ST vector pointed to the left-anterior-inferior direction. The S-T segment elevations in the right praecordial leads in these patients were due to the large magnitude of the maximal spatial ST vector. Its magnitude indirectly caused S-T segment elevation in the right praecordial leads adjacent to it during the acute stage of pericarditis.

Acute Disease↗
PubMedDate not supplied

Listeria monocytogenes pericarditis in a chronically hemodialyzed patient.

We describe the third documented case of Listeria monocytogenes pericarditis. This occurred in a 54-year-old woman with end-stage renal failure on chronic hemodialysis. Her initial presentation was one of Listeria monocytogenes bacteremia, which apparently responded to two weeks of cefazolin sodium therapy. After cessation of therapy the patient returned with Listeria monocytogenes pericarditis, this responding completely to four weeks of erythromycin therapy. We could not rule out coexisting endocarditis, especially since we found high levels of circulating immune complexes which subsided as the patient's condition improved. Further immunological studies displayed a decrease in cellular functions. This case illustrates the importance of Listeria monocytogenes as a human pathogen in immunocompromised patients. Listeria should be included among the potential causative agents of pericarditis in such patients.

Erythromycin↗
PubMed1981

Unsuspected purulent pericarditis detected by gallium-67 scanning: a case report.

A Ga-67 scan performed because of a suspected intraabdominal infection demonstrated marked pericardial uptake of the isotope instead, and thus provided the first clue to the diagnosis of purulent pericarditis. Subsequent studies and surgery revealed an esophagopericardial fistula, gas in the pericardial sac, and purulent pericarditis caused by multiple bacteria. This report presents an unusual cause of pericardial uptake of Ga-67. The use of Ga-67 scanning of diagnose purulent pericarditis in the absence of typical clinical findings is illustrated.

Adult↗
PubMed1980

Primary meningococcal pericarditis.

We have described two patients with primary meningococcal pericarditis. The first patient required open surgical drainage. In the second patient, pericardiectomy was eventually required. Thirteen cases of primary meningococcal pericarditis have now been reported. All the patients survived, in contrast to purulent pericarditis of other causes.

Adolescent↗