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PubMed1978

[Pericarditis of the heart niches (author's transl)].

Pericarditis of the Niches of the Heart (PNH) is an inflammatory process, progressing in stages, at the base of the pericardium. It is acquired during life and results finally in the formation of callosities. Lymphozytes, plasma cells, blood capillaries, and histiozytes as collagen fibres of various density characterize the PNH histologically. In 104 (48%) of 216 examined pericardiums of all age groups, PNH could be shown. The frequency of occurrence increases with age. No correlation to any fundamental disease was found. Mechanical influences are the primary cause of the origin of PNH. The pulsations affecting the plica of the base of the pericard as well as frictional, tensional and shear forces may initiate the process via small lesions of the serosa.

Acute Disease↗
PubMed1980

Irradiation-induced constrictive pericarditis requiring pericardiectomy during pregnancy.

Constrictive pericarditis is a rare but potentially life-threatening complication of pregnancy. This is a case report of irradiation-induced constrictive pericarditis requiring pericardiectomy during pregnancy. It is hoped that our team approach to this particular problem can serve as a model for the management of similar medical and surgical complications of pregnancy.

Adult↗
PubMed1980

[Cardiac alternation in pericarditis with effusion].

Alternation of the heart was revealed in 18 of 74 patients with tumorous pericarditis with effusion (24%). It was found most frequently in patients with a drastically enlarged heart and a large amount of exudate in the pericardial cavity. An electrical, mechanical and mixed character of alternation was encountered in pericarditis with effusion. Electrical alternation was caused by increased mobility of the heart in the fluid, mechanical alternation (pulsus alternans) was caused by diminished contractile function of the myocardium. In certain cases alternation of the heart is a reversible process and may disappear under the effect of treatment including irradiation, chemotherapy and pericardiocentesis.

Electrocardiography↗
PubMed1980

[Pericarditis in chronic compensated renal insufficiency].

In 80 patients with renal insufficiency we found 15 cases of pericarditis, demonstrated by the diagnostic means of echocardiography. The incidence of pericarditis increased with the rise in serum-creatinin and the severity of hypalbuminemia. These findings confirm the assumption that toxic capillary damage combined with lowered oncotic pressure might be a cause of pericardial effusion. Echocardiography as a reliable and non-invasive diagnostic method should be applied routinely in patients with chronic renal insufficiency--regarding potential therapeutic consequences--especially in patients with a concomitant incidence of hypalbuminemia and pleural effusion.

Adult↗
PubMed1980

[Association between viral infection and pleuropericarditis: study of a case list of pleurisy and pericarditis].

The Authors report a study on a group of 47 patients affected by serositis (pleuritis, pericarditis, pleuro-pericarditis) of suspected viral origin. Two serum samples were taken from each patient at different times and were tested with many viral antigens by the complement fixation technique. The discussion is carried out on the lines followed by the majority of people in giving importance to their viral etiology and the viruses involved as agents of serositis are reported. In the present study 18 patients (38%) showed a significant rise of antibodies for viral antigens and therefore their disease might be due to viral etiology: 5 influenza viruses, 1 parainfluenza, 1 coxsackie, 1 RSV, 3 mumps virus, 5 CMV, 1 adenovirus.

Adolescent↗
PubMed1981

Polymicrobial purulent pericarditis.

A 63-year-old man had polymicrobial purulent pericarditis secondary to a silent esophageal perforation into the pericardium. His hospital course was complicated and prolonged. Defunctioning of his esophagus was needed to cure his pericarditis. The authors recommend an aggressive approach to his rare condition, emphasizing the importance of early defunctioning of the esophagus.

Bacterial Infections↗
PubMed1995

[Recurrent pericarditis in familial Mediterranean fever].

The diagnosis of familial Mediterranean fever (FMF) is based on clinical evidence, since there is no specific diagnostic test. Manifestations are recurrent attacks of fever accompanied by serositis, mainly involving the peritoneum, pleura and joints. Although pericardial inflammation has been considered rare, when echocardiography is used to detect it, an incidence of 27% has been reported. We describe a boy of 11 and a girl of 15 years who developed recurrent pericarditis despite treatment with steroids, nonsteroidal anti-inflammatory drugs and pericardiocentesis. A few months after the first episode, both patients were admitted with typical bouts of FMF. Continuous prophylaxis with colchicine was initiated, and there were no further attacks during 18 and 10 month follow-ups, respectively. We conclude that acute or recurrent pericarditis in children or young adults of Mediterranean origin may be due to FMF.

Adolescent↗
PubMed1993

[Constrictive pericarditis after aortocoronary bypass. Apropos of a case].

We report a case of pericarditis following aorto-coronary by-pass surgery which gradually developed into chronic constrictive pericarditis. The disease was a long time ignored because symptoms are not specific. In our case the clinical presentation looked like a cirrhosis especially that our patient developed an hepatitis after blood transfusion. In this occasion criteria of diagnostic are reminded. Hemodynamic investigation is still the best method of diagnosis and the only treatment is surgical and consists of pericardial decortication.

Coronary Artery Bypass↗
PubMed1995

Streptococcal fibrinous pericarditis and peritonitis in a Vietnamese pot-bellied pig.

An 8-month-old female Vietnamese pot-bellied pig was examined because of a 48-hour history of anorexia and signs of depression. Hypothermia, dehydration, pronounced respiratory effort, and muffled heart sounds were detected. Abdominal ultrasonography revealed ascites and hepatic congestion. Echocardiography revealed pericardial effusion and fibrinous pericarditis. Ultrasound-guided pericardiocentesis was diagnostic and therapeutic. Cytologic examination of pericardial and peritoneal fluid revealed degenerated neutrophils and intra-and extracellular gram-positive cocci. On microbial culture of pericardial and peritoneal fluid specimens, moderate growth of a beta-hemolytic Streptococcus sp of group G was observed. After initial treatment corrected hypothermia and dehydration, the pig was treated with sulfadiazine/sulfamerazine/sulfamethazine and oxytetracycline for 30 days. Echocardiographic examination 3 months after the initial examination revealed resolution of the pericardial effusion and fibrinous pericarditis.

Animals↗
PubMed1994

[Neoplastic pericarditis secondary to ovarian adenocarcinoma. Report of a clinical case].

The pericardial metastatic disease is rare in genital cancers but is frequent in all other cancer. The authors report the case of a female affected by both papillary ovarian cancer and pericardial metastatic disease. Carcinomatous pericarditis began with cardiac tamponade. This pericarditis is very rare during ovarian cancer and there is little informations in the literature about it. The clinical picture showed an acuteness that cleared up with many pericardial tapping paracenteses, and after six cycles of polychemotherapy we obtained the disappearance of pericardial effusion and metastasis with total disappearance of abdominal metastases and the total remission of the cancer.

Adenocarcinoma↗
PubMed1994

[Lymphoblastic lymphoma of the renal cavity associated with hemorrhagic pericarditis. Description of a case].

The authors describe a case of lymphoblastic lymphoma of the renal lodge complicated by hemorrhagic pericarditis, cardiac tamponade and quickly evolved in an unfavourable way. Lymphoblastic lymphoma is classified into lymphocytic lymphomas (or non-Hodgkin) with a higher grade of malignancy. These lymphomas have, in 40% of cases, an initially extra-lymph node localization: among these, the renal or perirenal localization is not very frequent. The concomitant presence of a pericarditis of hemorrhagic type is also less frequent. Unlike Hodgkin's lymphomas, lymphocytic lymphomas are frequently in an advanced stage at the moment of diagnosis, and their evolution is of acute-subacute, often fatal type. The case report is about a 70 year old male, who arrived at the clinical investigation for the subjective presence of asthenia, dyspnea, tachycardia and the objective evidence of jugular turgor, hepatomegaly and distal edemas, hypophonesis of right lung basis, according to a clinical picture of systemic venous congestion which instrumental examinations confirm to be of pericardial origin. The abdominal echographic examination showed an occupation of the perirenal space, so the CAT characterized as a 25 cm long formation (from the renal cavity to pelvis), with a dislocation of close structures. Unfortunately, the clinical picture had a quick evolution towards the exitus for cardiac tamponade, only permitting us a bioptic examination for the diagnosis of the case.

Aged↗
PubMed1995

[Prediction of ineffective outcome of surgical treatment for constrictive pericarditis].

The preoperative factors predicting the outcome of surgical treatment for constrictive pericarditis were investigated in 22 patients with constrictive pericarditis who underwent pericardiectomy. The NYHA functional class was improved in nine patients after surgery (improved group), but not in the other 13 patients (unimproved group). Preoperative right and left heart catheterization data and echocardiograms were compared between these two groups. Right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) were significantly higher in the unimproved group. The left atrial diameter (LAD) measured by echocardiography was significantly greater in the unimproved group. These results indicate that pericardiectomy will cause a worsened immediate outcome in patients with severe pericardial constriction. LAD was the most useful parameter in predicting the ineffectiveness of the pericardiectomy. If the borderline value of LAD is taken as 40 mm, the sensitivity and specificity predicting ineffective surgery were 92% and 89%, respectively. RAP and PCWP could not separate the two groups satisfactorily. Pericardiectomy should be performed before the pericardial constriction progresses, and before LAD reaches 40 mm.

Adult↗
PubMed1995

[Acute pericarditis--clinical quality control trial].

Quality control aims to analyze not only the results of therapy but the efficiency and cost effectiveness of diagnostic procedures. In a catamnestic analysis of the outcome in 97 patients with acute pericarditis seen at this hospital from 1982 to 1992, we tried to answer the question whether a conservative diagnostic strategy might harm the patient. The outcome in 33 patients after limited diagnostic activity (patient story, clinical status; WBC differential count, ESR; creatinine and creatine kinase; ECG and chest x-ray) was the same as in 33 patients who underwent additional diagnostic procedures. Moreover, in patients in whom after limited diagnostic activity the etiology of acute pericarditis (precordial pain and friction rub) remained unclear, additional diagnostic procedures did not settle the problem. We conclude that extensive and even invasive diagnostic procedures are justified in selected patients and in special circumstances only (fever > 38 degrees and protracted course of disease, marked pericardial effusion or threatening tamponade; epidemiological or scientific interest).

Acute Disease↗
PubMed1993

Chronic active myocarditis simulating constrictive pericarditis-like findings: report of a case.

A 34-year-old female with rhythm disturbance and characteristic hemodynamic features of constrictive pericarditis is presented. A left ventricular wall open needle biopsy revealed mild mononuclear cell infiltration suggestive of myocarditis. The patient died of intractable heart failure seven years later. The autopsy revealed left and right ventricular dilatation, multiple foci of mononuclear cell infiltration, and diffuse replacement fibrosis in 31%, 13% and 14% of the areas of the left ventricular free wall, ventricular septum, and right ventricular wall, respectively, predominantly in the inner layers (68%). The pericardium was intact. These clinically constrictive pericarditis-like findings are considered to be secondary to chronic active myocarditis.

Adult↗
PubMed1993

[Value of radionuclide ventriculography and magnetic resonance imaging in the diagnosis of constrictive pericarditis].

In suggestive clinical presentations, the diagnosis of constrictive pericarditis is confirmed by the haemodynamic findings of impaired ventricular filling (diastole). In this study of 15 patients with pure constrictive pericarditis, the diagnosis value of two non-invasive techniques little used in this indication until now was examined: radionuclide ventriculography (RV) and magnetic resonance imaging (MRI). The RV provides a "functional" diagnosis through the analysis of global and segmental left ventricular filling whilst MRI provides anatomical details of the pericardial thickening. Diastolic dysfunction on RV presented as an increased early diastolic filling time as shown by a shortening of the interval to third filling T1/3R (p < 0.0001), an increased peak diastolic E wave velocity (p < 0.01) and early onset (p < 0.001), increased one third (FR 1/3) and mid (FR 1/2) diastolic filling fractions (p < 0.01) and of the E wave velocity to maximal systolic ejection velocity (S) ration (p < 0.01). The atrial contribution to filling in end diastole decreased (NS). Asynchronous filling, shown by dispersion of the times of onset of segmental early diastolic E peak velocities (delta tE) or of one third diastolic filling delta T1/3R, decreased. Seven patients underwent MRI. Pericardial thickening was present in all patients. The pericardium varied from 6 to 14 mm thick (normal 2.5 +/- 0.7 mm), without any systolo-diastolic variation. The thickening was seen as a dark low intensity signal, indicating the fibro-calcific character of the tissues. Sagittal and coronal views clearly demonstrated the non-uniformity of pericardial thickening.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Acute purulent pericarditis in children caused by haemophilus influenzae.

Acute purulent pericarditis caused by Haemophilus influenzae is an unusual condition, especially in childhood. In most cases, respiratory symptoms are the presenting features, and children aged less than 4 years are most often affected. A high index of suspicion and aggressive microbiological and cardiological evaluation are often warranted to make an early diagnosis. We herein report two cases of pericarditis caused by H. influenzae in children aged less than two years. Pericardiocentesis was performed in each case. Early recognition, rapid diagnosis and aggressive medical and surgical therapy are paramount in the successful treatment of this condition.

Acute Disease↗
PubMed1993

[A case of radiation-induced chronic constrictive pericarditis developing 16 years after irradiation].

We reported a 51-yr-old female with radiation-induced chronic constrictive pericarditis. At age 29, she had received a mastectomy and postoperative irradiation because of left breast cancer. At age 45, she had syncope and was diagnosed with complete atrioventricular block and a pacemaker was implanted. At that time, pericardial thickening with effusion was noted. The following year, tricuspid regurgitation was noted. On catheter study, a dip and plateau pattern of the right ventricular pressure curve appeared. At age 50, tricuspid regurgitation worsened due to the lead wire of the pacemaker compressing the leaflet, and the pacemaker was reimplanted. However, the following year, she complained of general fatigue and dyspnea and was admitted to our hospital. On 67Ga study, diffuse accumulation in the cardiac region appeared. There was no perfusion defect detected in the left myocardium, but right myocardial damage was suspected by thallium study. In 99mTc-HSA RI angiography, right atrium dilatation appeared and a pericardial halo around the ventricles was seen. She underwent pericardectomy, tricuspid replacement and pacemaker reimplanted, but she died. On autopsy, pericardial thickening and adhesion, right myocardial fibrosis, the fibrotic change of the bundle branches were seen. We reported a case of radiation-induced constrictive pericarditis. Radionuclide studies were useful in diagnosing and following the patient.

Breast Neoplasms↗