Transient effusive-constrictive pericarditis is a rare complication of open-heart surgery, but is increasingly recognized. For patients with both pericardial effusion and constrictive physiology soon after uneventful open-heart surgery, proper treatment remains to be established. We experienced a case of transient effusive-constrictive pericarditis in a 50-year-old woman who underwent aortic valve replacement due to infective endocarditis. Initially, she was treated with both prednisolone and ibuprofen, which resulted in dramatic relief of symptom. However, she suffered from a relapse of pericaridis after rapid steroid discontinuation and was stabilized by re-treatment with steroid.
Aortic Valve ; Endocarditis ; Female ; Humans ; Ibuprofen ; Middle Aged ; Pericardial Effusion ; Pericarditis ; Pericarditis, Constrictive ; Postpericardiotomy Syndrome ; Prednisolone ; Recurrence

Effusive constrictive pericarditis after open heart surgery is a rare complication occuring in 0.2% to 0.3%. Presenting symptoms after surgery are associated with right heart failure and an elevated jugular venous pressure is most common abnormal physical sign. Predisposing factors include hemorrhage, perioperative pericardial injury or inflammation, presence of postpericardiotomy syndrome and open pericardium. Early diagnosis is important because(1) if it is unrecognized, the patient may deteriorate clinically, and(2) if surgery is delayed, the patient may have an increased risk of operative death. Hereby we report a case of effusive constrictive pericarditis after ventricular septal defect repair, in which constriction physiology was suggested by Doppler echocardiography after pericardiostomy.
Causality ; Constriction ; Early Diagnosis ; Echocardiography, Doppler ; Heart Failure ; Heart Septal Defects, Ventricular* ; Hemorrhage ; Humans ; Inflammation ; Pericardial Window Techniques ; Pericarditis, Constrictive* ; Pericardium ; Physiology ; Postpericardiotomy Syndrome ; Thoracic Surgery ; Venous Pressure

Postcardiac injury syndrome (PCIS) is an inflammatory process that usually occurs within 1 to 6 weeks after an injury to the pericardium, epicardium, or myocardium. As more interventions are performed for complicated coronary artery obstructive lesions, there have been some recent reports on PCIS following percutaneous coronary intervention (PCI). The medical management of PCIS depends on nonsteroidal anti-inflammatory drugs (NSAIDs), in addition to colchicine or steroids. An 80-year-old male patient underwent a PCI. Unfortunately, the guidewire piercing failed but he showed no immediate signs of complication. However, 5 hours after the procedure, he complained of chest discomfort. An electrocardiogram showed widespread ST elevation. Chest X-ray and computed tomography showed pulmonary congestion with pleural effusion, while thoracic echocardiography showed a moderate amount of pericardial effusion. NSAIDs were initiated, but there was no improvement of symptoms. We describe an unusual case of atypical earl onset PCIS after PCI, recovered rapidly by steroids.
Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal ; Colchicine ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Estrogens, Conjugated (USP) ; Humans ; Male ; Myocardium ; Percutaneous Coronary Intervention* ; Pericardial Effusion ; Pericardium ; Pleural Effusion ; Postpericardiotomy Syndrome ; Steroids* ; Thorax