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PubMed1989

[Peracute constrictive, idiopathic pericarditis--a case report of an acute life-threatening disease picture].

Generally, idiopathic pericarditis is considered a benign, self-limiting disease. Frequently, the exsudative phase of the disease is followed by a mild form of transitory constriction of the pericardium. The case reported here shows an unusual course of the disease. Shortly after the symptoms of exsudative pericarditis subsided a life-threatening form of pericardial constriction developed within weeks. In case of chronic pericardial constriction perioperative mortality for partial pericardiectomy is not insignificant. This is a result of myocardial damage that is difficult to assess prior to surgery. For that reason a partial pericardiectomy should be attempted as early as possible, even in cases with acute pericardial constriction.

Acute Disease↗
PubMedDate not supplied

[The x-ray diagnosis of exudative pericarditis].

Venous hypertension of lesser circulation was used as a criterion for differential diagnosis of diffuse lesion of the myocardium and exudative pericarditis. In 57 patients (31 with diffuse myocardial lesion and 26 with exudative pericarditis) the results of assessment of common x-ray symptoms were compared with signs of venous hypertension in this disease. The presence or absence of venous hypertension in the recognition of exudate into the pericardial cavity was emphasized.

Adult↗
PubMed1989

[Two cases of cardiac tamponade, complicated by malignant, effusive pericarditis and treated by creating a pericardial peritoneal window].

Reported are two cases of a cardiac tamponade complicated by a malignant, effusive pericarditis were treated by a pericardial, peritoneal window. In both cases, a reaccumulation of pericardial fluid was noticed, within a month after percutaneous, continuous pericardial drainage, and a tumor invasion was seen to the anterior mediastinum creating a pericardial, peritoneal window was considered useful for the treatment of the cardiac tamponade, secondary to the malignant, effusive pericarditis.

Adult↗
PubMed1989

Staphylococcal pericarditis. An atypical presentation.

Purulent pericarditis is typically an acute and often catastrophic illness. The case presented herein has unusual manifestations of pericarditis caused by Staphylococcus aureus. The clinical course was indolent and prolonged, and unlike the usual case, no primary source could be found.

Aged↗
PubMed1989

Constrictive pericarditis and anemia post myocardial infarction.

A 67-year-old male presented with acute inferolateral myocardial infarction complicated by transient acute post infarction pericarditis. Six weeks later, he developed Dressler's syndrome associated with moderately severe anemia of chronic disease. Both of these resolved over the next few weeks, however, shortly thereafter, right sided congestive heart failure occurred. This progressed despite medical therapy and the diagnosis of constrictive pericarditis was made 10 months post infarction. Total pericardectomy was done one year after the onset of acute myocardial infarction with complete resolution of signs and symptoms.

Aged↗
PubMed1989

[Pulmonary edema and pericarditis after inhalation of Teflon fumes].

Inhalation of fumes from pyrolysis of polytetrafluoroethylene (Teflon) is known to cause polymer fume fever, a mild syndrome of influenza-like symptoms of short duration. Occasionally more severe reactions occur. Several cases of pulmonary edema have been reported, only one of which was fatal. We report a case history of pulmonary edema and pericarditis following inhalation of fumes from grinding a Teflon coated surface. Pericarditis has not been reported previously in connection with polymer fume reactions. We discuss various aspects of such reactions, with reference to the case and to selected literature.

Adult↗
PubMed1988

Antimyosin antibodies and constrictive pericarditis in lupus erythematosus.

We report the first case of constrictive pericarditis in a woman with systemic lupus erythematosus (SLE). Immunopathologic studies demonstrated IgG, IgA, IgM and C3 distributed throughout her pericardium including vessel walls. Cardiospecific antimyosin, antisarcolemmal and antipericardial antibodies were detected in serum obtained prior to surgery or steroid therapy. Antibodies disappeared and creatine phosphokinase decreased to normal concentrations during prednisone therapy. Antimyosin antibodies were not detected in 11 sera or in one pericardial fluid obtained from patients with lupus with active pericarditis unaccompanied by constriction. Evaluation of antimyosin antibodies in other patients with this rare manifestation of SLE is warranted to further assess their pathologic significance.

Adult↗
PubMedDate not supplied

[Diagnosis of constrictive pericarditis and restrictive cardiomyopathy by pulsed Doppler echocardiography].

Characteristics of flow through atrioventricular valves were analyzed by pulsed Doppler echocardiography (PDE) in 7 patients with either constrictive pericarditis or restrictive cardiomyopathy and 10 controls to determine the value of this technique in their differentiation. All patients were admitted with systemic venous congestion and underwent right and left heart catheterization. PDE variables considered included peak flow velocity (PV), acceleration time, peak velocity of the atrial component (PVA), PVA/PV quotient, duration of early diastolic fillings, deceleration of early diastolic filling, duration of diastolic flow and mean temporal velocity. Ventricular filling differed between patients and controls in that the former group was characterized by higher PV's, lower PVA's, higher deceleration and lower PVA/PV quotient. When we compared both patient groups we found a significant tendency toward higher PV's, faster deceleration and lower PVA/PV quotient in constrictive pericarditis.

Adult↗
PubMedDate not supplied

Constrictive pericarditis following coronary bypass reoperation. Fibrotic pericardium and a foreign body reaction.

A 65-year-old male patient underwent two bypass operations because of coronary artery disease. After the second operation he developed congestive heart failure with breathlessness, ankle swelling, hepatomegaly and poor exercise tolerance. Echocardiographic and haemodynamic findings were characteristic of constrictive pericarditis. Pericardiectomy was performed three months after the second operation. The retrosternal space was replaced with fibrotic, patchy hyalinic tissue, and the pericardium was thick and rigid. Histologically, the thickened pericardium showed dense fibrosis and foreign-body granulomas with large multinuclear giant cells and irregular crystals. This report indicates that foreign body reaction following coronary artery bypass operation may result in constrictive pericarditis with severe heart failure.

Aged↗
PubMed1986

[Features of the course and evaluation of the efficacy of surgical treatment of adhesive pericarditis with constriction].

Two groups of patients with constrictive pericarditis were identified on the basis of clinical and instrumental examination including echocardiography and computerized tomography of the heart: patients with complete obliteration of the pericardial sac and constriction, and those with exudative/adhesive pericarditis and constriction. Part of the patients were subjected to subtotal pericardectomy. An improvement of left-ventricular diastolic function and hemodynamic parameters was demonstrated 1 to 1.5 months after the operation. Postoperative echocardiography showed persistent disorders of interventricular septum movement and multilayer abnormal echoes in the left-ventricular posterior wall area.

Adult↗
PubMed1986

Management of uremic pericarditis.

Five uremic patients with hemodynamically significant pericardial effusion, which did not respond to conservative treatment (intractable effusion) or tamponade, were treated with instillation into the pericardial sac of a nonabsorbable steroid, triamcinolone hexacetonide, and with intermittent drainage. This was done by insertion of a drainage catheter into the pericardial space under direct vision by subxiphoid pericardiotomy performed under local anesthesia. All patients responded well to the procedure, and immediate relief of the symptoms was achieved. No complications of the procedure were observed, and the drainage catheters were removed 48 to 72 h thereafter. Two patients died of unrelated causes--1 month and 3 years after the events. Two other patients are still alive and on a hemodialysis program, and one has a functioning kidney graft. During the 3 to 8 years of follow-up, no recurrent pericarditis was observed, and no constrictive pericarditis developed in any patient.

Administration, Topical↗
PubMed1978

[Clinical and paraclinical changes in cattle with traumatic pericarditis before and after pericardial puncture].

A puncture of the pericardium has been performed on cows with a traumatic pericarditis. The clinical status has been taken and paraclinical investigations prior to and after the puncture have been carried out. Following a puncture of the pericardium, up to the 12th hour, the movements of the rumen decrease or entirely disappear, and are restored again later, while respiratory movements and the heart activity become ever more frequent. A leucocytosis occurs without a trend towards a return to the initial level as well as neutrophilia with a nuclear left-shifting to metamyelocytes. The clinical and paraclinical changes in cattle with a traumatic pericarditis, after a puncture of the pericardium, point to a deterioration in the condition and a possible exitus.

Animals↗
PubMed1985

[Constrictive pericarditis as a late complication of heart operations].

Constrictive pericarditis is a rare complication of previous cardiac surgery, the rate of incidence being approximately 0.1 to 0.3%. Until now about 60 cases have been documented. With increasing frequency of surgical procedures, especially bypass operations, cardiac surgery plays a major role in the etiology of pericardial constriction. In our own series of 12 consecutive pericardiectomies previous cardiac surgery was in 4 cases responsible for the constriction. These cases are presented in detail. A correct diagnosis is difficult and - as in our own cases - often not noticed for a long period of time because the symptoms are obliterated by the primary heart disease and the previous operation. In our own patients the diagnosis was eventually established by echocardiography and then confirmed by right sided heart catheterization. Due to the late diagnosis the results of pericardiectomy - considered the method of choice - were only poor. Two patients, both in a very bad overall condition, died soon after surgery. The remaining 2 patients recovered satisfactorily. Regarding the pathogenesis, hematomas seem to play a leading role in the development of subsequent pericardial fibrosis. Typically the patients present symptoms of a prolonged pericarditis soon after the original surgical intervention. The time between cardiac surgery and the development of constrictive features varies between weeks and years. The postoperative course of patients with excessive postoperative bleeding or larger pericardial effusions should be watched carefully, keeping the possibility of later pericardial constriction in mind.

Aortic Valve↗
PubMed1986

[Management of cardiac tamponade in uremic pericarditis].

Pericarditis with tamponade is known to occur in patients with chronic renal failure. It is an acute life-threatening emergency which requires immediate intervention. 6 patients with cardiac tamponade complicating uremic pericarditis who were treated at our institution from 1975 to 1984 are described. The diagnosis of pericardial tamponade was made by 2 D-echocardiography in the presence of jugular vein distension and pulsus paradoxus. Drainage by a percutaneously inserted pigtail catheter after subxiphoidal puncture was performed. Initial drainage of 707 (200-1660) ml fluid resulted in rapid improvement of the hemodynamic findings: the systolic blood pressure increased from 118 +/- 18 (SD) mm Hg to 157 +/- 16 mm Hg, the pulse pressure from 45 +/- 9 mm Hg to 79 +/- 11 mm Hg and the central venous pressure decreased from 21 +/- 6 cm H2O to 14 +/- 4. The catheters were left in place for a mean 61 (23-90) hours until no further fluid accumulated. As supportive measures, non-absorbable steroids were instilled via the percardial catheters and dialysis treatment was intensified. No complications were observed and no recurrence of effusion or development of constriction was noted for 9 to 35 months. In conclusion, subxiphoidal pericardiostomy with prolonged drainage and local steroid instillation has been found to be an effective and safe method which provides immediate and lasting relief.

Cardiac Catheterization↗
PubMed1985

Acute pericarditis. An unusual presentation of an exacerbation of ulcerative colitis.

Acute pericarditis is an unusual complication of ulcerative colitis. In some rare cases, it is the only extraintestinal manifestation of the underlying colitis, and may even precede the development of bowel symptoms. Less rarely, pericarditis may be the presenting feature of an exacerbation of ulcerative colitis. Such a case is reported to illustrate the important, but uncommon, association of these disorders, and to discuss the implications for management.

Adrenal Cortex Hormones↗
PubMed1985

[Chlamydial infection in pericarditis in pigs].

An etiologic study was carried out for the presence of Chlamydia in the case of pericarditis in pigs on a large swine-breeding complex. Investigated were some clinical, epizootiologic, and morphologic aspects of the disease. A strain of Chlamydia psittaci was isolated in chick embryos from pericardial liquids of affected animals. It was identified through electron-microscopic and antigenic studies. Elementary and initial bodies of Chlamydia were seen in ultrathin sections of the infected yolk sacs. Eatherial-and-acetone group-specific antigens that were purified on Sepharose 2B and 4B were obtained. The disease was contracted chiefly by pigs at the age of 30-70 days. The clinical picture was not strictly indicative. Disease cases were recorded in all seasons of the year. Both the gross lesions and the histologic findings spoke of serofibrinous pericarditis.

Animals↗
PubMed1979

[Uremic pericarditis. Preliminary evaluation of treatment with indomethacin (author's transl)].

Numerous therapeutic schemes have been proposed for pericarditis, whether or not accompanied by pericardial effusion in patients with terminal chronic renal insufficiency of subjects on periodic hemodialysis. All of the authors agree that dialysis must be initiated, or at least must not be interrupted once it is begun. There is some disagreement over the system that should be used (peritoneal dialysis or hemodialysis). Anti-inflammatory drugs have been used in association, since the condition is an inflammatory disease. Five episodes of pericarditis with daily hemodialysis and local heparine were treated, plus five other cases with the addition of 3 mg indomethacin/kg/day for 8 days. No secondary effects of indomethacin were reported. A definite reduction in the duration of pain, fever, pericardial rub, and increase in the size of the cardiac shadow was seen in the episodes treated with the association of indomethacin. This furthermore involved the number of days the patient was subjected to hemodialysis. Partial pericardiectomy was practiced on two patients not treated with indomethacin. The later course of the patients treated with indomethacin was more favorable since pericardial effusion did not lead to significant hemodynamic symptoms. There were no recurrences or other complications.

Adult↗