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PubMed1979

Constrictive pericarditis: early and late complication of cardiac surgery.

Constrictive pericarditis is not considered a complication of cardiac surgery. However, three cases are presented in which equalization of diastolic pressures and the ventricular pressure pattern of early diastolic dip-late diastolic plateau, characteristic of restrictive disease, appeared after cardiac surgery. In one patients cardiac constriction developed less than 2 weeks after surgery, and loculated clotted and unclotted viscous blood was removed from the pericardial space. In the other two patients the pericardial space was obliterated by dense adhesions. Thus constrictive pericarditis should be considered in postoperative patients who either do not recuperate satisfactorily after surgery or whose condition deteriorates after initial recovery.

Aged↗

PubMed1980

Early diastolic sound of constrictive pericarditis.

In two patients with constrictive pericarditis an absent or faint early diastolic sound became prominent with squatting, phenylephrine infusion or injection of contrast medium and was obliterated by nitroglycerin. The lability of the sound allowed correlations to be made with acute changes in the right ventricular pressure curve. By eliciting an otherwise inaudible early diastolic sound, squatting may be a useful bedside maneuver in the diagnosis of constrictive pericarditis.

Adult↗

PubMed1980

Clotted hemopericardium with the hemodynamic characteristics of constrictive pericarditis.

Cardiac catheterization in a patient 4 weeks after coronary arterial bypass surgery demonstrated the typical hemodynamic findings of constrictive pericarditis, which completely resolved after removal of 500 ml of clotted pericardial blood. The pericardium was not responsible for the findings because it was left in place. This case demonstrates that clotted hemopericardium may mimic constrictive pericarditis.

Aged↗

PubMed1982

Constrictive pericarditis: new aspects.

The current status of constrictive pericarditis is reviewed with regard to its etiology, physical signs, electrocardiographic findings, and hemodynamic features. Angiographic aspects are also presented. The role and limitations of M-mode echocardiography in this disease are emphasized. The value of other noninvasive studies such as measurement of systolic time intervals, myocardial scanning, and high-speed echocardiography is described. Emphasis is placed on the invasive and noninvasive methods that may be useful in separating restrictive cardiomyopathy from constrictive pericarditis. Methods of treatment, indications for pericardial resection, and the current operative results are commented on briefly.

Angiocardiography↗

PubMed1984

Pericarditis resulting from infection and fistula between the left ventricle and transverse colon.

A patient is described who presented with acute pericarditis and acute ulcerative colitis. Previous resection of a left ventricular apical aneurysm had been performed four years earlier, and no problems had arisen until pericarditis developed. After hospital admission and investigation, the patient's condition suddenly deteriorated, and he died. Autopsy showed the causes of death to be a fistula between the left ventricle and transverse colon and septicemia.

Colitis, Ulcerative↗

PubMed1990

Futility of pericardiectomy for postirradiation constrictive pericarditis?

Two patients underwent pericardiectomy for postirradiation constrictive pericarditis. Both had received radiotherapy (more than 6,000 rads) for treatment of Hodgkin's disease 17 (patient 2) and 20 years (patient 1) earlier. At the time of operation, the patients were in New York Heart Association functional class III-IV or IV. Preoperative catheterization showed the following pressures for patients 1 and 2, respectively: right atrial, 30 and 14 mm Hg; right ventricular end-diastolic, 28 and 14 mm Hg; wedge, 29 and 13 mm Hg; and left ventricular end-diastolic, 27 and 14 mm Hg. Complete epicardiectomy and pericardiectomy was attempted in both patients. However, hospital mortality was 100%; patient 1 died of multiorgan failure after six days, and patient 2 died of biventricular failure after 3 months. A review of the literature revealed 44 cases of pericardiectomy for postirradiation constrictive pericarditis and a late survival rate of less than 50%. The poor results in these patients compared with patients having pericardiectomy for other reasons seem to be due mainly to the various kinds of radiation-induced damage to the heart as a whole, including untimely coronary artery disease, myocardial fibrosis, atrioventricular conduction disturbances, and valve dysfunction, with the result that complete relief by epicardiectomy and pericardiectomy may not be technically feasible.

Adult↗

PubMed1994

Chronic cardiac rejection masking as constrictive pericarditis.

The hemodynamic changes consistent with constrictive pericarditis are often encountered in patients who have undergone cardiac transplantation. We describe here 4 patients who underwent pericardiectomy after cardiac transplantation. All were found to have evidence of a thickened and constricting peel of pericardium at surgical exploration. Their postoperative clinical courses were variable. One patient with primarily effusive constriction experienced marked improvement. Three patients failed to show clinical improvement and had persistently elevated atrial and ventricular end-diastolic pressures. A coexisting restrictive cardiomyopathy secondary to chronic rejection, coronary arteriopathy, or long-standing constriction may have been the cause of this poor outcome. Many patients with transplanted hearts exhibit evidence of poor diastolic ventricular compliance without evidence of classic constriction; some manifest both the restrictive and constrictive components. The careful selection of patients with constrictive pericarditis can optimize the outcome.

Adult↗

PubMedDate not supplied

Traumatic pericarditis in an Awassi lamb.

A case of traumatic pericarditis in a 4-month-old Awassi lamb is reported. A 6 cm long metallic wire was found penetrating the pericardium and the left ventricle through to the other side of the ventricle wall. Fibrinous pericarditis, thickening of the pericardium, fusion of the pericardium and epicardium, and epicarditis were evident. The heart was enlarged with oedematous myocarditis and focal necrotic endocarditis involving the two ventricles. The liver and spleen were also enlarged with scattered 3 mm diameter granulomas.

Animals↗

PubMed1987

Pericarditis: complication of esophageal sclerotherapy. A report of three cases.

Three patients developed acute pericarditis while undergoing esophageal sclerotherapy for bleeding varices. One patient required pericardiocentesis and the other 2 patients had spontaneous resolution of the pericarditis. This previously unreported complication of sclerotherapy must be considered in the differential diagnosis of those patients who develop postsclerotherapy chest pain.

Adult↗

PubMed1986

Primary meningococcal pericarditis in a pregnant woman.

Pericardial effusion is an unusual complication of meningitis due to Neisseria meningitidis. Primary meningococcal pericarditis without signs of meningitis is rare. Only 18 cases have been described in the literature. The first case was reported in 1939 and the others since 1971. We report a case of primary meningococcal pericarditis in a pregnant woman. Improvement followed prompt antibiotic therapy. Fetal death necessitated abortion by curettage.

Adult↗

PubMed1988

Amoebic pericarditis.

An unusual case of chronic amoebic pericarditis is reported in which the diagnosis of pericarditis was suggested on chest X-ray. The echocardiographic feature of multiple cystic lesions were mainly related to the left ventricle, there was thickening of the visceral pericardium, and some restriction to ventricular filling. The cysts contained anchovy sauce like material, and serological tests for amoebiasis were strongly positive. There was no evidence of an amoebic liver abscess. Clinically the patient improved with anti-amoebic treatment, but died later having refused surgery. The clinical picture may have been modified by earlier chloroquine administration.

Amebiasis↗

PubMed1992

Right atrial thrombus in constrictive pericarditis.

We describe right atrial thrombus complicated by tricuspid valve obstruction in a patient with constrictive pericarditis. This report highlights the role of surgical thrombectomy, and the investigation of constrictive pericarditis to exclude intra-cardiac thrombus.

Adult↗

PubMed1993

Atrio-ventricular regurgitations in constrictive pericarditis: incidence and post-operative outcome.

We studied 33 surgically proven cases of constrictive pericarditis during the period 1989-1991 by color Doppler echocardiography and angiography to look for incidence and postoperative outcome of atrioventricular regurgitation. The mean age was 27.2 + 16.5 years (21 males, 12 females). There was a very high incidence of mitral (79%, trivial in 13, mild in 11 and moderate in 2) and tricuspid (73%, trivial in 7, mild and moderate in 6 each and severe in 5) regurgitation. There was good correlation between 'color Doppler' and angiography for detection and quantification of these regurgitations (r = 0.89 for mitral and 0.76 for tricuspid regurgitation, respectively). There were no preoperative clinical or hemodynamic predictors for the incidence or severity of these regurgitations. Immediate postoperative (7-10 days) evaluation by color Doppler did not show any change in these regurgitations. A follow-up study (by color Doppler and angiography) in 18 patients at a mean period of 229 + 105 days revealed regression of these regurgitations by at least 1 grade in 50% of patients. Patients with persisting regurgitations had persisting hemodynamic abnormality and relatively longer duration of symptoms. The presence of atrio-ventricular regurgitations should not be taken as evidence favoring diagnosis of restrictive cardiomyopathy and against that of constrictive pericarditis. The mechanism of these regurgitations is not clear to us.

Adult↗

PubMed1985

Survival of an extensively burned infant following purulent pericarditis.

This is a report of the treatment and survival of an extensively burned infant following purulent pericarditis with massive pericardial effusion due to Staphylococcus aureus. A 2-year-old boy fell into a bathtub and suffered scalds covering at least 70 per cent of the body surface area. Pericarditis with massive pericardial effusion was diagnosed on post-burn day 36. As conservative treatment was ineffective pericardiotomy and pericardial drainage were carried out. Whole body oedema disappeared promptly and entirely and the patient was discharged from hospital with healed burns and free of cardiac symptoms.

Burns↗

PubMed1991

Pyogenic pericarditis in a patient with burns--a rare complication.

We report a patient with 60 per cent of the body surface area burned who developed pyogenic pericarditis which was treated successfully by open pericardial drain. In an estimated 1000 patients with burns treated in this hospital over a period of 5 years from 1984 to 1989, this is the first patient developing pyogenic pericarditis. A possible pathological basis for the sequence of events is discussed.

Adult↗

PubMed1991

Purulent pericarditis in an adult burn patient treated with survival.

A 41-year-old white-skinned male admitted with 40 per cent total body surface area partial and full skin thickness burns developed septic pericarditis. He had a severe inhalation injury and subsequent pneumothorax. Multiple fibreoptic bronchoscopies were required. The septic pericarditis required pericardectomy which was carried out in two stages. The extensive burns required multiple operations. The patient eventually made a complete recovery.

Adult↗

PubMed1986

Pathophysiology of primary meningococcal pericarditis associated with Neisseria meningitidis group C. A case report and review of the literature.

Pericarditis associated with Neisseria meningitidis in the absence of meningitis or meningococcemia is an extremely rare event. We report herein a case of a 59-yr-old woman with primary meningococcal pericarditis caused by Neisseria meningitidis group C. The patient responded to a course of penicillin therapy and recovery was uncomplicated. The pathophysiologic features underlying or contributing to the disease are discussed and the pertinent literature is reviewed.

Cardiac Tamponade↗

PubMed1995

Polymicrobial bacterial pericarditis with mediastinitis after endotracheal intubation.

Polymicrobial bacterial pericarditis with mediastinitis after traumatic endotracheal intubation is an unusual condition. We report a 54-year-old man, a victim of nasopharyngeal carcinoma, who developed pericardial effusion with tamponade after traumatic endotracheal intubation. The diagnosis of polymicrobial bacterial pericarditis was made when pericardiocentesis revealed purulent fluid that grew a mixed culture of anaerobic and aerobic bacteria, reflecting the normal upper airway flora. By bronchoscopic study, a laceration over the lower trachea was detected. The patient received prolonged aggressive antibiotic therapy and pericardial drainage. The infection improved, but the patient later died from another episode of nosocomial infection.

Anti-Bacterial Agents↗