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PubMed2006

[Differential characteristics of primary acute pericarditis and severe pericardial effusion without tamponade].

The aim or our study was to evaluate the main clinical and etiological features or primary acute pericarditis with severe pericardial effusion without cardiac tamponade. Our experience included 35 patients with this problem diagnosed in the last 5 years. Patients with a previous potential etiology for acute pericarditis were excluded. The diagnostic protocol identified a specific etiology in 20% of patients, the most frequent being idiopathic forms. Patients with severe pericardial effusion without cardiac tamponade who had a favourable clinical outcome on nonsteroidal antiinflammatory drugs therapy presented a lower proportion of specific etiology than those with a poor response to this therapy (8% versus 45%; p = 0.03). An exhaustive etiological investigation, including diagnostic pericardiocentesis should be reserved for these patients with unfavourable response to antiinflammatory drug therapy.

Acute Disease↗

PubMed1976

Constrictive pericarditis with dwarfism in two siblings (mulibrey nanism).

Two siblings with marked dwarfism, now 11 and 19 years of age, have been followed from infancy. The girl had frequent episodes of pneumonitis and presented at age 4 years with hepatic enlargement and ascites which proved to be due to constrictive pericarditis. The boy presented with growth failure and pseudohydrocephalus. He had fibrous dysplasia of the tibia and a pathologic fracture; acute hepatic congestion followed physical activity at age 13 years and led to the diagnosis of constrictive pericarditis. Muscle function was normal, there was no evidence for a primary liver disorder, and mental development was normal so that the coined word "mulibray" seemed inappropriate. Pericardiectomy produced only partial improvement; both patients have hepatic enlargement and continue to need diuretics. A third patient with dwarfism, frequent respiratory infections, and pericardial calcification has certain features of the syndrome.

Adolescent↗

PubMed1984

Constrictive pericarditis associated with combined idiopathic retroperitoneal and mediastinal fibrosis.

Idiopathic retroperitoneal fibrosis and mediastinal fibrosis are localized expressions of a systemic sclerosing disease of unknown cause which, on rare occasions, may coexist in the same patient. Although pericardial involvement may occur, recurrent constrictive pericarditis that is unrelieved by pericardiectomy has not previously been reported in association with either idiopathic retroperitoneal or mediastinal fibrosis. Reported herein is a case of recurrent constrictive pericarditis that was unrelieved by two pericardiectomies , and autopsy revealed unsuspected combined idiopathic retroperitoneal and mediastinal fibrosis. The clinical, echocardiographic, and pathologic findings are described.

Echocardiography↗

PubMed1983

Subacute constrictive pericarditis from Serratia marcescens bacteremia.

A case report of subacute constrictive pericarditis associated with disseminated Serratia marcescens infection and bacteremia in a patient with chronic tubulointerstitial nephritis and uremia is described. Although not substantiated by clinical history, the renal pathologic features were similar to those of ethylene glycol-induced tubulointerstitial nephritis. The patient did not have a history of heroin addiction. The importance of predisposing factors such as uremia, invasive vascular procedures, tracheal intubation, peritoneal dialysis, and pericardiocentesis in Serratia infection in susceptible persons is discussed, as are possible roles of uremia, pericardiocentesis, and pericardiotomy in the pathogenesis of constrictive pericarditis in the present case.

Adult↗

PubMed1985

Constrictive calcific pericarditis following coronary arterial bypass surgery.

A case of postsurgical constrictive calcific pericarditis is reported. The unusual features of this case are the short interval (two months) from surgery to the development of pericarditis and the involvement of the coronary arterial grafts, resulting in tearing of the vessels and the death of the patient during decortication.

Aged↗

PubMedDate not supplied

Fibrinous pericarditis in hepatorenal failure.

During a period of two years pericarditis was observed in five patients with decompensated cirrhosis who had only slightly raised blood-urea-nitrogen and serum-creatinine. Although this association has not been previously described, some patients with hepatic failure seem to have pericarditis in the absence of severe uraemia.

Acute Kidney Injury↗

PubMed1981

Coeliac disease presenting as recurrent pericarditis.

Recurrent pericarditis was the presenting feature in two patients with coeliac disease. Treatment with a gluten-free diet led to clinical and electrocardiographic improvement of the pericarditis.

Adolescent↗

PubMed1985

Severe constrictive pericarditis after single 16 MeV anterior mantle irradiation for Hodgkin's disease.

Severe constrictive pericarditis developed in 4 of 73 patients after single anterior 16 MeV mantle field irradiation for Hodgkin's disease. 3 patients (4.1%) died; the other had successful pericardectomy. Use of a single anterior mantle field of high-energy X-rays is clearly more hazardous than conventional opposed-field techniques, and the resulting radiation pericarditis is difficult to treat.

Adolescent↗

PubMed1997

Legionella feeleii pneumonia and pericarditis.

Legionella feeleii pneumonia has been described in seven cases, three of them being immunocompromised. We describe a case of L. feeleii pneumonia and pericarditis in a healthy man. Epidemiological survey was not conclusive. To the best of our knowledge, there have been no previous descriptions of pericarditis caused by this organism.

Humans↗

PubMed1981

Experimental model of leukemic infiltrative pericarditis reflecting a human disease.

In human leukemias, pericarditis may be associated with leukemic pericardial infiltration. In order to obtain more information about the pathogenesis of the leukemic involvement of the pericardium, sterile talc-induced pericarditis was produced in acute lymphoid leukemic male hybrid mice. The animals invariable showed leukemic pericardial infiltration within 14 days. In leukemic mice without any treatment or with intrapericardial physiological NaCl injection (instead of talc), leukemic involvement of the pericardium did not occur.

Animals↗

PubMed2001

[Cholesterol crystals pericarditis].

Cholesterol pericarditis is an uncommon, specific form of pericardial disease that is characterized by the presence of cholesterol crystals in pericardial fluid. The etiology may be either idiopathic or in association with systemic disorders such as tuberculosis, rheumatoid arthritis, myxedema or hypercholesterolemia. We report a case of cholesterol pericarditis in a 51-year-old male who was diagnosed with chronic renal failure due to polycystic kidney disease. To our knowledge no similar cases have been reported to date in the literature.

Cholesterol↗

PubMed1999

[Acute pericarditis with effusion as a form of presentation of psittacosis].

Psittacosis is an uncommon cause of acute pericarditis and pericardial effusion. However, some isolated cases have been reported. We present a case which the first clinical feature of psittacosis was acute pericarditis. Severe pericardial effusion associated with a pulmonary infiltrate and an epidemiologic history of contact with avian species suggested the diagnosis of psittacosis, confirmed by serological test.

Acute Disease↗

PubMed1999

[Recurrent acute pericarditis associated with adult-onset Still's disease treated with pericardiectomy].

Recurrent acute pericarditis associated with adult onset Still's disease is an unusual feature. We present a case with recurrent episodes of acute pericarditis with cardiac tamponade which only improved with corticosteroid therapy. Because of the severe and frequent recurrences and corticodependence development, a subtotal pericardiectomy was performed with a good outcome after a 12-month observation period.

Adult↗

PubMed1998

A case of effusive-constructive pericarditis: an efficacy of GD-DTPA enhanced magnetic resonance imaging to detect a pericardial thickening.

A 38-year-old man underwent pericardiectomy because of effusive-constrictive pericarditis. The gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced magnetic resonance imaging showed pericardial thickening separate from the effusion, which could not be shown by unenhanced computed tomography. Gd-DTPA enhanced magnetic resonance imaging could be useful for the early detection of effusive-constrictive pericarditis.

Adult↗

PubMed2000

Single site radiofrequency catheter ablation of atrial fibrillation: studies guided by simultaneous multisite mapping in the canine sterile pericarditis model.

OBJECTIVES: To test the hypothesis that when activation of Bachmann's bundle (BB) is critical to the unstable reentrant circuits that maintain atrial fibrillation (AF) in the sterile pericarditis canine model, a lesion in BB would prevent induction of stable AF. BACKGROUND: One mechanism of induced AF in this model is multiple unstable reentrant circuits, which frequently include BB as part of the reentrant pathway. METHODS: Simultaneous multisite mapping studies during AF and after ablation of BB were performed by recording (384 to 396 electrodes) from both atria and the atrial septum during six induced AF episodes in six dogs with sterile pericarditis. Activation maps of AF (mean duration, 24 +/- 28 min) during 12 consecutive 100-ms windows were analyzed. RESULTS: During AF, multiple unstable reentrant circuits (mean, 1.2 +/- 0.2 per window; range, 1 to 4) were observed, 68% involving BB. Nonactivation zones (mean duration, 57 +/- 16 ms in the right atrium and 53 +/- 23 ms in the left atrium) observed during AF were reactivated by a wave front most often coming from the atrial septum via BB (right atrium, 62%; left atrium, 67%). After successful radiofrequency catheter ablation of the midportion of BB, AF >5 s was not induced in all dogs. Mapping studies of transient AF (< or =5 s) induced after ablation showed neither reentrant circuits nor wave fronts activating the right atrium via BB. CONCLUSIONS: In this AF model, catheter ablation of BB terminates and prevents the induction of AF by preventing 1) formation of unstable reentrant circuits that involve BB, and 2) activation of the atrial-free walls after a nonactivation period.

Animals↗

PubMed1983

Differentiation of constrictive pericarditis and restrictive cardiomyopathy using digitized echocardiography.

Constrictive pericarditis and restrictive cardiomyopathy are difficult to distinguish at the bedside and occasionally at routine cardiac catheterization. Left ventricular diastolic function was studied by computer analysis of digitized M-mode echocardiograms in four patients with constrictive disease and three with restrictive disease, and the data were compared with those of normal subjects. The respective distinguishing echographic features of constrictive pericarditis and restrictive cardiomyopathy were as follows: the major filling period of the left ventricle was 78 +/- 9% of normal versus 128 +/- 4% (p less than 0.01), minimal left ventricular dimension to peak filling interval was 50 +/- 10 versus 110 ms (p less than 0.05) and the maximal rate of left ventricular posterior wall thinning was -4.9 versus -2.3 seconds-1 (p less than 0.05). This preliminary study suggests that it may be possible to accurately diagnose the two disease entities using this technique at the bedside and to avoid cardiac catheterization.

Adolescent↗

PubMed2003

Purulent pericarditis caused by malignant oesophago-pericardial fistula.

A case of purulent pericarditis with an unusual aetiology and a favourable outcome is reported. This patient presented with purulent pericarditis secondary to an oesophago-pericardial fistula caused by a squamous carcinoma of the oesophagus. A review of the literature revealed only a small number of similar cases. The prognosis can be improved by rapid diagnosis, appropriate antibiotic therapy, surgical drainage and surgical repair of the fistula. An aggressive therapeutic approach should be proposed in order to achieve long-term remission in these frequently young patients.

Adult↗

PubMed2001

Constrictive chronic pericarditis in children.

Constrictive pericarditis is a uncommom disease in children. We have now encountered pericardial thickening as the cause of severe constrictive physiology in two patients, one also having haemodynamic features of restrictive cardiomyopathy. Both patients, who had refractory ascites and evidence of increased systemic venous pressure, underwent Doppler echocardiography, cardiac catheterisation, and magnetic resonance imaging. Resonance imaging failed to show any thickning of the pericardium, but cardiac catheterisation revealed diastolic equalisation of pressures in all four chambers, with only mild elevation of pulmonary pressure in the first patient, but nearly equalisation of diastolic pressure, and a very high pulmonary arterial pressure with a difference of 7 mm Hg between the end diastolic pressures in the two ventricles in the second patient. Doppler revealed a restrictive pattern of mitral inflow, with high E and small A velocities and a short deceleration time. The clinical background did not suggest pericardial disease in either of the patients. We conclude that a careful search is needed to uncover constrictive pericarditis when there is no previous disease which may suggest late pericardial constriction. The haemodynamic features of restrictive cardiomyopathy can co-exist with pericardial restriction, and differentiation between the two entities is critical in view of the diverse management and prognosis of the two conditions.

Child↗