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At least 1,009 records · Page 56Linked to original sources
PubMed1999

Doppler sonographic diagnosis of severe portal vein pulsatility in constrictive pericarditis: flow normalization after pericardiectomy.

This case report describes the noninvasive assessment of hepatic and portal vein hemodynamics in a patient with constrictive pericarditis before and after pericardiectomy. Doppler sonography of the hepatic veins demonstrated a typical W-shaped pattern with pronounced late diastolic flow reversal that disappeared after surgery. Preoperatively, we observed severe pulsatility of the portal vein with flow reversal in systole; after pericardiectomy, portal venous flow was normal. We concluded that the high right atrial pressure in this patient might have led to increased hepatic venous outflow resistance, with subsequent trans-sinusoidal shunting between the hepatic artery and portal vein causing severe portal vein pulsatility. After pericardiectomy and a decrease in right atrial pressure, portal vein flow normalized.

Adolescent↗
PubMed1998

Pseudoaneurysm of the thoracic aorta presenting as purulent pericarditis and pericardial effusion.

Report of a case of a mycotic pseudoaneurysm of the ascending thoracic aorta occurring in the absence of surgical or blunt trauma in a patient who presented with purulent pericarditis. Surgical pericardial drainage was required, which revealed Staphlococcal aureus. Subsequent transesophageal echocardiogram demonstrated a 4 cm x 4 cm pseudoaneurysm of the posterior wall of the aorta above the sinotubular junction. The patient refused surgical correction of the aortic pseudoaneurysm and was successfully managed with antibiotic therapy.

Aneurysm, False↗
PubMed2000

Staphylococcal pericarditis following percutaneous transluminal coronary angioplasty.

Infectious complications occurring after percutaneous transluminal coronary angioplasty are uncommon. We are reporting a case of bacterial pericarditis developing 1 week after coronary angioplasty and stent implantation. Treatment with appropriate antibiotics and drainage of the infected pericardial effusion was followed by a protracted hospital course and eventual control of infection and discharge of the patient.

Angioplasty, Balloon, Coronary↗
PubMed2000

Clinical variability and genetic homogeneity of the camptodactyly-arthropathy-coxa vara-pericarditis syndrome.

The camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP) is an autosomal recessive condition characterized by the association of congenital or early onset camptodactyly and noninflammatory arthropathy with synovial hyperplasia. Progressive coxa vara deformity and/or noninflammatory pericardial or pleural effusions have been observed in some patients. Recently, the disease gene has been assigned to human chromosome region 1q25-q31, and truncating mutations have been identified in the megakaryocyte stimulating factor gene. Studying 12 patients from 8 unrelated families, we emphasized hip and spine involvement, particularly in the course of the disease as shown in a 58-year-old patient. Despite clinical variability, linkage studies support genetic homogeneity of the disease.

Adolescent↗
PubMed1989

Cyclosporin A in the treatment of severe aplastic anemia: description of a case complicated by the development of tubercular pericarditis during treatment.

We report on a 62 year-old woman who developed a severe aplastic anemia requiring frequent packed red cell and platelet transfusions. Since conventional pharmacological therapy was ineffective, treatment with Cyclosporin A was started, resulting in a significant increase of leukocyte, platelet, and red cell counts. However, 5 months after the beginning of Cyclosporin A treatment, despite a past medical history not significant for clinical tuberculosis, the patient developed tubercular pericarditis. This report underlines the need for a careful follow-up of Cyclosporin A-treated patients aimed at a prompt diagnosis of possible infectious complications.

Anemia, Aplastic↗
PubMed1984

Hemodynamic profile of constrictive pericarditis produced by a massive right pleural effusion.

We report a 29-year-old female who presented with thyrotoxicosis and a massive right pleural effusion. Cardiac catheterization in the presence of the effusion revealed equalization of abnormally elevated right and left heart filling pressures. Repeat study after thoracentesis demonstrated normal intracardiac pressures, which were unchanged by volume loading with normal saline. This case report suggests that both extrinsic cardiac chamber compression produced by the large unilateral effusion and ventricular interdependence altered diastolic function of the right and left ventricle in a manner resembling constrictive pericarditis or restrictive cardiomyopathy.

Adult↗
PubMed1982

Hemophilus influenzae pericarditis.

Although Hemophilus influenzae infections have long been considered to be a disease of childhood, recent reports have demonstrated an increasing frequency of serious Hemophilus influenzae infections in adults. A case of purulent H. influenzae pericarditis in a previously healthy adult without evidence of concurrent H. influenzae infection is reported.

Adult↗
PubMed1995

Pulmonary venous flow in constrictive pericarditis.

A 35-year-old white female patient presented with radiation-induced constrictive pericarditis. Intraoperative transesophageal echocardiography revealed a uniphasic diastolic flow pattern. This pulmonary flow pattern reverted to a normal biphasic systolic/diastolic profile immediately following radical pericardiectomy. This abnormal flow pattern was previously described as typical for restrictive cardiomyopathy. However, in this case it is most likely due to a marked decrease in left atrial compliance induced by the thick fibrous scar encasing the atrial.

Adult↗
PubMed1997

"Tombstone" anterior ST-segment elevations secondary to acute pericarditis: the role of two-dimensional echocardiogram.

Prompt and appropriate administration of thrombolytic therapy is important for patients with acute myocardial infarction. However, in addition to contraindications, alternative causes of ST-segment elevation should be considered before thrombolytic therapy is instituted. A patient with marked ST-segment elevation in the anterior leads suggestive of acute ischemia is presented. Because of lack of ischemic symptoms, an echocardiogram was performed. This showed mild generalized hypokinesis, and thrombolytic therapy was not administered. Subsequent ECGs demonstrated evolutionary findings consistent with pericarditis. In selected patients a two-dimensional echocardiogram, which can be easily performed at patient bedside, will help in appropriate patient management.

Aged↗
PubMed1999

Intrapericardial treatment of inflammatory and neoplastic pericarditis guided by pericardioscopy and epicardial biopsy--results from a pilot study.

From a registry of 136 patients undergoing pericardiocentesis, 14 patients with autoimmune and 15 patients with neoplastic effusions were selected. All underwent pericardioscopy, epicardial and pericardial biopsy with histologic, immunohistologic, and polymerase chain reaction/or in situ hybridization analysis for microbial DNAs and RNA. Pericardioscopy identified neoplastic effusions by the high occurrence of protrusions. Fibrin threads and layers and neovascularization were found in both groups. For identification of the inflammatory and neoplastic process, the combined analysis of the cytology of the effusion and epicardial biopsy evaluation proved to be most important. Epicardial biopsy demonstrated a slightly higher sensitivity for identifying neoplastic disorders in the pericardium than cytology alone. Pericardial biopsy was inconclusive. Intrapericardial administration of 1 g of crystalloid triamcinolone in autoreactive pericarditis prevented recurrence in 13 of the 14 cases after 3 months and in 12 of the 14 cases after 1 year. In neoplastic effusion, intrapericardial administration of 50 mg cis-platin for 24 h prevented recurrence of a hemodynamically relevant effusion after 3 months in all, and after 6-12 months in 14 of 15 patients. Mortality in neoplastic effusion due to noncardiac tumor progression was 47 and 80%, respectively, after 3 and 6 months, as can be expected in endstage neoplastic disease. This pilot study demonstrates that local drug application is feasible, life-saving, and well tolerated by the patients. It opens perspectives for local drug application in other cardiac disorders as well.

Adolescent↗
PubMed2003

Echocardiographic diagnosis and follow-up of left ventricular pseudoaneurysm complicating bacterial pericarditis.

Two-dimensional echocardiography demonstrated a pseudoaneurysm of the lateral wall of the left ventricle in a 13-year-old girl with bacterial pericarditis. The echocardiographic findings included a 5-mm discontinuity in the lateral wall of the left ventricle, an associated anechoic collection (5.6 x 5.1 cm), and a narrow communication between the left ventricle and the anechoic collection. Color Doppler imaging demonstrated flow through the communication between the left ventricle and the aneurysmal cavity. The patient and her family refused surgery. A follow-up echocardiographic examination more than 6 years later demonstrated disappearance of the discontinuity of the left ventricular lateral wall, no flow between the left ventricle and the pseudoaneurysm, and thrombus formation within the pseudoaneurysm.

Adolescent↗
PubMed1984

Mediastinal emphysema simulating acute pericarditis.

A case of extensive subcutaneous emphysema, retropneumoperitoneum and mediastinal emphysema is described. The mediastinal emphysema was associated with signs and symptoms of pericardial tamponade, and previously undocumented ECG changes, consistent with acute pericarditis, were noted.

Acute Disease↗
PubMed1988

Intrapericardial triamcinolone hexacetonide in the treatment of intractable uremic pericarditis in a child.

Uremic pericarditis in children on chronic hemodialysis represents a difficult management problem, necessitating vigorous medical therapy and often surgical drainage of the pericardial effusion. Standard therapeutic approaches have met with limited success. The successful use of intrapericardial triamcinolone in a 10-year anephric boy on chronic dialysis is reported and accompanied by a description of the technique applied and literature review.

Cardiac Catheterization↗
PubMed1978

Proteins of ascitic fluid in constrictive pericarditis.

A patient with chronic calcific pericarditis, hepatic congestion, and fibrosis had massive ascites with a protein concentration of 5.1 g/100 ml. This fluid was in all likelihood largely derived from hepatic interstitial fluid. The ascites-serum concentration ratio for several protein species and molecular exclusion chromatography of these fluids suggested two processes may be involved in the transfer of protein from serum to ascites, namely bulk transfer of all species and molecular sieving.

Adolescent↗
PubMed1990

An unusual presentation of staphylococcal pericarditis.

An atypical presentation of purulent pericarditis caused by Staphylococcus aureus is described. A bacterial etiology was initially not taken into consideration because the clinical course was torpid and afebrile. Therefore, the appropriate treatment was delayed. The patient recovered after percutaneous pericardial drainage of his purulent pericardial effusion and antimicrobial therapy. The importance of a high index of suspicion of a bacterial cause in patients with pericardial effusion of unexplained etiology is emphasized.

Bacteriuria↗
PubMedDate not supplied

Meningococcal pericarditis in the absence of meningitis.

A 16 year-old female presented with cardiac tamponade due to purulent meningococcal pericarditis without concomitant meningitis or meningococcaemia. She recovered after aspiration of the pericardial effusion and administration of a high dose of benzylpenicillin via a continuous infusion.

Adolescent↗
PubMedDate not supplied

Tuberculous pericarditis as the first manifestation of AIDS.

Although it is known that extrapulmonary tuberculosis in patients with AIDS has a broad spectrum of clinical manifestations, pericardial involvement has rarely been described. We report a case of this condition as the first manifestation of AIDS with good response to antituberculous therapy. Although unusual, the diagnosis of tuberculous pericarditis in symptomatic HIV-infected patients should be aggressively pursued because of the beneficial clinical response to treatment.

Acquired Immunodeficiency Syndrome↗