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PubMed1987

Haemophilus influenzae pericarditis successfully treated by catheter drainage.

Surgical drainage together with antibiotic therapy is generally considered the treatment of choice for purulent pericarditis. A case of culture-proven Haemophilus influenzae pericarditis is described in a young, previously healthy adult. Successful management of his illness included placement of an indwelling pericardial catheter and intravenous antibiotics. Pericardial catheter drainage may be an alternative to surgical drainage in some cases of purulent pericarditis.

Adult↗
PubMed2004

Pericarditis after meningococcal infection: case report of a child with two distinct episodes.

Pericarditis is a recognized consequence of meningococcal disease. The incidence among all age groups is 3 to 19%. Repeated episodes of pericarditis after meningococcal disease have been reported previously in two adults but not in children. We describe the clinical and laboratory features of a child with two distinct episodes of pericarditis after Neisseria meningitidis serogroup C infection.

Adolescent↗
PubMed2005

Myocarditis, pericarditis and cardiomyopathy in patients treated with clozapine.

Clozapine is known to cause cardiac side-effects, including myocarditis, pericarditis and cardiomyopathy. Prompted by a case of clozapine-related pericarditis in our hospital we undertook a review of the literature for reports of myocarditis, pericarditis and cardiomyopathy occurring in patients treated with clozapine. This is the first comprehensive review of the literature on this topic.

Cardiomyopathies↗
PubMed1992

Recurrent pericarditis: a rare complication of allergen immunotherapy.

We report on a 29-year-old woman suffering from hay fever due to grass and olive tree pollens. She developed recurrent pericarditis during her first course of immunotherapy with an alum-adsorbed pollen extract. A causal relationship was established between the allergen injections and the acute pericarditis episodes on two consecutive occasions, which presented with blood eosinophilia. Blood cultures and serological tests for microorganisms were negative. There were no signs of autoimmune disease or systemic vasculitis. To the best of our knowledge, allergen immunotherapy-induced pericarditis has not been previously reported.

Acute Disease↗
PubMed1997

Microbiology and pathology of fibrinous pericarditis in Danish slaughter pigs.

The prevalence of fibrinous pericarditis detected at slaughter in Danish slaughter pigs is approximately 0.02%. The microbiology and pathology of this disorder was studied through 46 field cases collected at slaughter from May 1994 to August 1995. Mycoplasmas (Mycoplasma hyopneumoniae, M. hyosynoviae and M. hyorhinis) were isolated from the pericardium in 38 cases and from the joints in six. M. Hyopneumoniae dominated with 33 isolates from the pericardium. Actinobacillus pleuropneumoniae was isolated from the pericardium in three cases (as mono-infection in one and together with M. hyopneumoniae in two cases) and Actinomyces pyogenes was isolated from the pericardium twice (as mono-infection in one case and together with M. hyopneumoniae in another). A. pyogenes was also present in the lung, liver and kidney in one of these cases. Streptococcus suis was isolated together with mycoplasmas from the pericardium in three cases. The pericardium was sterile in three cases and contained a low grade mixed flora in two; the latter is believed to be a result of the slaughter procedure rather than an infection. No chlamydiae were found in connection with the microbiological examination. Parvovirus was found in one case in the pericardium and in two cases in the spleen. Forty-five cases were subacute to chronic. The gross pathological examination showed that bronchopneumonia, chronic pleuritis and synovitis or a low grade arthritis occurred in most cases. Only the arthritic lesions are believed to be pathogenetically concurrent with the pericarditis. Slight evidence of stasis of the liver and/or periangiolar edema was present in six cases. The histopathological examination confirmed the above mentioned findings. Bacterial colonies were found within the fibrinous layer on the pericardium in all cases from which either A. pleuropneumoniae, A. pyogenes or S. suis was isolated. It is concluded that in this study mycoplasmas, particularly M. Hyopneumoniae, are the more likely cause of fibrinous pericarditis in slaughter pigs.

Animals↗
PubMed2005

Protein-losing enteropathy as the principal manifestation of constrictive pericarditis.

Constrictive pericarditis represents a rare cause of protein-losing enteropathy due to intestinal lymphangiectasia. We report the case of a patient with an atypical clinical presentation of constrictive pericarditis and protein-losing enteropathy as its principal manifestation; he was successfully treated with pericardiectomy. We conclude that, constrictive pericarditis should be considered in the presence of protein losing enteropathy and also, protein-losing enteropathy should be considered in the differential diagnosis of hypoalbuminemia.

Aged↗
PubMed2006

Acute pericarditis unmasks ST-segment elevation in asymptomatic Brugada syndrome.

A 26-year-old man was admitted to our hospital because of acute pericarditis. The current patient had a saddle-back type ST-segment elevation shortly after the onset of acute pericarditis. Interestingly, it converted into a coved type ST-segment elevation, subsequently regressed gradually as acute inflammation improved. After 3 months, right ventricular rapid pacing induced ventricular fibrillation, and intravenous sodium channel blocker induced a coved type ST-segment elevation. The current case implies that a Brugada-type ST-segment elevation, which is thought to be false in acute pericarditis, may be true in some patients with asymptomatic Brugada syndrome.

Acute Disease↗
PubMedDate not supplied

The radiographic appearance of reticular diaphragmatic herniation and traumatic pericarditis in buffaloes and cattle.

Survey radiography is used in diagnosis of different affections in buffaloes and cattle. The aim of the present study was to assess the role of radiography in diagnosis of reticular diaphragmatic hernias and traumatic pericarditis in buffaloes and cattle. The present study was carried out on 69 animals (51 buffaloes and 18 cattle). Reticular diaphragmatic hernias (40 buffaloes, 4 cattle) and traumatic pericarditis (11 buffaloes, 14 cattle) were evaluated. Lateral right-left survey radiography of the thorax was performed. In diaphragmatic hernia, radiography revealed presence of a rounded or vertical oval mass of soft tissue opacity superimposed over the heart. Radiopaque foreign bodies of variable shape and size were seen within the herniated part of the reticulum. The apex of the heart was difficult to visualize. With traumatic pericarditis, survey radiography of the thorax revealed poor differentiation of thoracic contents. The contour of the diaphragm was lost and the cardiac silhouette was obscured. In several animals radiopaque foreign bodies (sewing needles, nails, and pieces of wire) were detected at the level of the heart or in the area connecting the dome of the diaphragm with the heart.

Animals↗
PubMed2002

Immunohistochemical characterisation of the lesions of canine idiopathic pericarditis.

Pericardial tissue was obtained from 14 dogs with idiopathic pericarditis, and from three dogs with pericardial effusion associated with neoplastic disease, for histopathological assessment and characterisation of infiltrating leucocytes by immunohistochemistry. The major pathological change was extensive pericardial fibrosis which was generally accompanied by a mixed inflammatory response that was of greatest intensity at the cardiac surface of the tissue. Perivascular lymphoplasmacytic aggregates were present at the pleural surface and within the fibrosed pericardium. There were no features that clearly distinguished the samples from dogs with neoplastic disease from dogs with idiopathic pericarditis. The pericardial infiltrates were dominated by MAC 387+ monocyte-macrophages and plasma cells expressing immunoglobulin (Ig)A or IgG. CD3+ T lymphocytes and major histocompatibility complex (MHC) class II+ macrophages were less common, although the perivascular aggregates were mixtures of T and B lymphocytes and a proportion of fibroblasts expressed MHC class II. There was no vascular pathology or deposition of immunoglobulin or complement within vessel walls. These findings are consistent with an immune response dominated by humoral effector mechanisms (Th2 immunity) but do not clearly support a primary immune-mediated pathogenesis for idiopathic pericarditis.

Animals↗
PubMed1987

A case of subacute effusive constrictive pericarditis with a probable amoebic aetiology.

A 48 year old man with amoebic pericarditis did not improve after pericardiocentesis. Facilities for echocardiography and haemodynamic studies were not available. Cardiac compression was suspected and at emergency pericardiectomy subacute effusive constrictive amoebic pericarditis was found. The patient recovered. This is believed to be the first report of a case of subacute effusive constrictive pericarditis caused by amoebiasis.

Amebiasis↗
PubMed1987

Combined pericarditis and pneumonia caused by Legionella infection.

During a one year period acute pericarditis was diagnosed in 16 consecutive patients without acute infarction or malignancy. In two of these patients with both pericarditis and pneumonia Legionella infection was present. One case was caused by Legionella longbeachae and the other by both Legionella longbeachae and Legionella jordanis. When pericarditis is associated with pneumonia Legionella infection should be sought so that effective treatment with erythromycin may be started early.

Adult↗
PubMed1998

Carcinoid heart disease from ovarian primary presenting with acute pericarditis and biventricular failure.

A case is described of a 54 year old woman who had acute pericarditis with large exudative effusion accompanied by severe right and left ventricular failure. The patient was finally diagnosed with carcinoid heart disease from an ovarian carcinoid teratoma. She was treated with octreotide--a somatostatin analogue--followed by radical surgical resection of the neoplasm. At one year follow up only mild carcinoid tricuspid regurgitation remained. Only 16 cases of carcinoid heart disease from an ovarian primary have been described in literature. Moreover clinically manifest acute, nonmetastatic pericarditis and left heart failure are not considered as possible presentations of carcinoid heart disease, whatever the origin. In a recent series a small pericardial effusion was considered an infrequent and unexpected echocardiographic finding in carcinoid heart patients. One case of "carcinoid pericarditis" has previously been described as a consequence of pericardial metastasis. Left sided heart involvement is usually caused by bronchial carcinoids or patency of foramen ovale; both were excluded in the case presented.

Carcinoid Heart Disease↗
PubMed1991

Asbestos induced pericardial effusion and constrictive pericarditis.

The number of disorders attributable to asbestos exposure has increased gradually over the years. The latest to be recorded is pericardial effusion and constrictive pericarditis, and three cases are reported here. A man with bilateral pleural thickening and plaques developed acute pericarditis and an effusion and was treated by pericardiectomy. Two men died from constrictive pericarditis associated with bilateral pleural effusions and diffusion pleural thickening. The pericardium showed nonspecific fibrous thickening. All had been occupationally exposed to asbestos. In the fatal cases the lungs contained amphibole fibres, in keeping with a modest degree of occupational exposure. Asbestos produces progressive fibrosis of the pericardium that is similar to diffuse pleural thickening and may be fatal. Both conditions may develop after relatively short or light exposure.

Adult↗
PubMed1997

Azathioprine-induced pericarditis in a patient with ulcerative colitis.

Inflammatory bowel disease is rarely associated with pericarditis but both sulfasalazine and the aminosalicylates have been known to cause this complication. To the author's knowledge this is the first reported case of acute pericarditis caused by azathioprine. It is believed that pericarditis is yet another potential manifestation of hypersensitivity to this drug.

Adult↗
PubMed2006

Pericarditis after high-dose chemotherapy: more frequent than expected?

BACKGROUND: Pericarditis is a rare side-effect of chemotherapy and has been reported following administration of cyclophosphamide, doxorubicin and other drugs but not treosulfan. CASE REPORTS: We report on 2 patients with retrosternal chest pain and typical widespread upward concave ST-segment elevation in the 12-lead electrocardiogram prompting the diagnosis of acute pericarditis. The patients had received treatment for multiple myeloma or relapsed mantle cell lymphoma with high-dose treosulfan alone or in combination with etoposide and carboplatin followed by autologous stem cell transplantation 5 days before onset of the symptoms. In both patients, no serological evidence of viral infection was found. Serum creatine kinase and serum cardiac troponin I remained unchanged. Within 24 h of onset of the symptoms, C-reactive protein increased from normal values (< 5 mg/l) to 95 mg/l and 115 mg/l, respectively. In one of the patients, a paroxysmal supraventricular arrhythmia occurred that persisted for 2 days. After treatment with diclofenac, both patients recovered completely within 1 week. CONCLUSION: The differential diagnosis of chest pain in the setting of high-dose chemotherapy with e.g. treosulfan should include pericarditis. The pathogenesis remains unclear. Alongside infections, direct toxic or immunological drug-related mechanisms are suggested.

Aged↗
PubMed1989

Differentiation of constrictive pericarditis and restrictive cardiomyopathy by Doppler echocardiography.

Doppler ultrasound recordings of mitral, tricuspid, aortic, and pulmonary flow velocities, and their variation with respiration, were recorded in 12 patients with a restrictive cardiomyopathy and seven patients with constrictive pericarditis. Twenty healthy adults served as controls. The patients with constrictive pericarditis showed marked changes in left ventricular isovolumic relaxation time and in early mitral and tricuspid flow velocities at the onset of inspiration and expiration. These changes disappeared after pericardiectomy and were not seen in patients with restrictive cardiomyopathy or in normal subjects. The deceleration time of early mitral and tricuspid flow velocity was shorter than normal in both groups, indicating an early cessation of ventricular filling, but only patients with restrictive cardiomyopathy showed a further shortening of the tricuspid deceleration time with inspiration. Diastolic mitral and tricuspid regurgitation was also more common in the patients with restrictive cardiomyopathy. These results suggest that patients with constrictive pericarditis and restrictive cardiomyopathy can be differentiated by comparing respiratory changes in transvalvular flow velocities. In addition, although baseline hemodynamics in the two groups were similar, characteristic changes were seen with respiration that suggest differentiation of these disease states may also be possible from hemodynamic data.

Adult↗
PubMed1990

Recurrent pericarditis. Relief with colchicine.

Recurrence is one of the major complications of pericarditis. Treatment of recurrence is often difficult, and immunosuppressive drugs or surgery may be necessary. We conducted an open-label prospective study of nine patients (seven men and two women; age, 18-64 years; mean age, 41.7 +/- 13.7 years). Patients were treated with colchicine (1 mg/day) to prevent recurrences. All patients had suffered at least three relapses despite treatment with acetylsalicylic acid, indomethacin, prednisone, or a combination. Pericarditis was classified as idiopathic in five patients, postpericardiotomy in two, post-myocardial infarction in one, and associated with disseminated lupus erythematosus in one. For statistical analysis, we conducted a paired comparison design (Student's t test). All patients treated with colchicine responded favorably to therapy. Prednisone was discontinued in all patients after 2-6 weeks (mean, 26.33 +/- 10.9 days), and colchicine alone was continued. After a mean follow-up of 24.3 months (minimum, 10 months; maximum, 54 months), no recurrences were observed in any patient; there was a significant difference between the symptom-free periods before and after treatment with colchicine (p less than 0.002). Our study suggests that colchicine may be useful in avoiding recurrence of pericarditis, although these results need to be confirmed in a larger, double-blind study.

Adolescent↗
PubMed1997

Preload reduction to unmask the characteristic Doppler features of constrictive pericarditis. A new observation.

BACKGROUND: Respiratory variation of > or = 25% in mitral E velocity is a characteristic Doppler echocardiographic feature in constrictive pericarditis. However, a subset of patients with constriction do not exhibit the typical respiratory change, most likely because of marked increase in the left atrial pressure, and preload reduction may unmask the respiratory variation. METHODS AND RESULTS: In 12 patients with surgically confirmed constrictive pericarditis who had < 25% respiratory variation in mitral E velocity during an initial preoperative examination, the Doppler study was repeated after an attempt to decrease left ventricular filling pressure. At baseline, mean mitral E velocity was similar after inspiration and expiration (0.81 +/- 0.24 and 0.84 +/- 0.21 m/s, respectively). On repeat Doppler examination, with the patient in a head-up tilt or sitting position the decrease in mitral E velocity with inspiration (0.61 +/- 0.13 m/s) was significant (P < .004), whereas it did not change significantly with expiration. The mean percent respiratory change in E velocity was 5 +/- 7% at baseline and 32 +/- 28% with preload reduction. Eight (75%) of the 12 patients developed respiratory variation of > or = 25%. CONCLUSIONS: When the respiratory variation in Doppler mitral E velocity is blunted or absent during the evaluation of suspected constrictive pericarditis, repeat Doppler recording of mitral flow velocities after maneuvers to decrease preload is recommended to unmask the characteristic respiratory variation in mitral E velocity.

Echocardiography↗