Pericarditis is a rare manifestation of tuberculosis (Tb) in children. A 14-yr-old Korean boy presented with cardiac tamponade during treatment of pulmonary tuberculosis. He developed worsening anemia and persistent fever in spite of anti-tuberculosis medications. Echocardiography found free floating multiple discoid masses in the pericardial effusion. The masses and exudates were removed by pericardiostomy. The masses were composed of pink, amorphous meshwork of threads admixed with degenerated red blood cells and leukocytes with numerous acid-fast bacilli, which were confirmed as Mycobacterium species by polymerase chain reaction. The persistent fever and anemia were controlled after pericardiostomy. This is the report of a unique manifestation of Tb pericarditis as free floating masses in the effusion with impending tamponade.
Adolescent ; Cardiac Tamponade/etiology ; Echocardiography ; Humans ; Male ; Pericardial Effusion/*diagnosis/etiology/surgery/ultrasonography ; Pericardiectomy ; Pericarditis, Tuberculous/complications/*diagnosis/ultrasonography

No abstract available.
Aged ; Biopsy ; Humans ; Liver Cirrhosis/diagnosis/*etiology/therapy ; Male ; Pericarditis, Constrictive/*complications/diagnosis/therapy ; Tomography, X-Ray Computed

Behcet's disease with concomitant thrombotic thrombocytopenic purpura (TTP), coronary artery stenosis and coronary artery pseudo aneurysm is rare. Here we report a case of Behcet's disease with several cardiovascular complications, namely: pericarditis, deep vein thrombosis (DVT), TTP, coronary artery stenosis, and a coronary artery pseudo aneurysm. A 37-year-old female presented with sudden dyspnea and syncope at our emergency room and underwent pericardiectomy and pericardial window formation for the diagnosis of cardiac tamponade with acute hemorrhagic pericarditis. Thereafter, TTP and DVT complicated her illness. After confirmation of Behcet's disease on the basis of a history of recurrent oral and genital ulcers and erythema nodosum, remission was achieved after treatment with methylprednisolone pulse therapy, colchicine, catheter directed thrombolysis and thrombectomy. However, whilst maintaining anticoagulation therapy, a newly developed pericardial aneurysmal dilatation was noted on follow-up radiologic evaluation. Further evaluation revealed right coronary artery stenosis and a left coronary artery pseudo aneurysm; these additional problems were treated with the nonsurgical insertion of an endovascular graft stent . At the time of writing three months later after stent insertion, the aneurysm has continued to regress and no additional complications have intervened with combined immunosuppressive therapy.
Venous Thrombosis/diagnosis/*etiology ; Purpura, Thrombotic Thrombocytopenic/diagnosis/*etiology ; Pericarditis/diagnosis/*etiology ; Humans ; Female ; Echocardiography ; Coronary Vessels/*physiopathology ; Coronary Stenosis/diagnosis/*etiology ; Cardiac Tamponade/diagnosis/*etiology ; Behcet Syndrome/*complications/diagnosis ; Aneurysm, False/diagnosis/*etiology ; Adult

A retrospective analysis of clinical data of 71 patients with constrictive pericarditis (CP) diagnosed by echo-Doppler technique (mean age, 49 +/- 17) was done. In 27 patients (38%), the etiology was unknown, and the three most frequent identifiable causes were tuberculosis (23/71, 32%), cardiac surgery (8/71, 11%), and mediastinal irradiation (6/71, 9%). Pericardiectomy was performed in 35 patients (49%) with a surgical mortality of 6% (2/35), and 11 patients (15%, 11/ 71) showed complete resolution of constrictive physiology with medical treatment. Patients with transient CP were characterized by absence of pericardial calcification, shorter symptom duration, and higher incidence of fever, weight loss, and tuberculosis. The 5-yr survival rates of patients with transient CP and those undergoing pericardiectomy were 100% and 85 +/- 6%, respectively, which were significantly higher than that of patients without undergoing pericardiectomy (33 +/- 17%, p=0.0083). Mediastinal irradiation, higher functional class, low voltage in ECG, low serum albumin, and old age were the independent variables associated with a higher mortality. Tuberculosis is still the most important etio-logy of CP in Korea, and not infrequently, it may cause transient CP. Early diagnosis and decision-making using follow-up echocardiography are crucial to improve the prognosis of patients with CP.
Adult ; Aged ; Cardiac Surgical Procedures/adverse effects ; *Echocardiography, Doppler ; Female ; Follow-Up Studies ; Human ; Male ; Mediastinum/radiation effects ; Middle Age ; Pericarditis, Constrictive/etiology/surgery/*ultrasonography ; Pericarditis, Tuberculous/ultrasonography ; Pericardium/surgery

OBJECTIVETo summarize the clinical and pathological characteristics of constrictive pericarditis in China.

METHODData from 150 patients with constrictive pericarditis who admitted to our hospital from 2000 to 2007 were retrospectively analyzed.

RESULTSConstriction pericarditis was detected by echocardiography in 149 out of 150 patients. Pericardial effusion was evidenced in 59.3% patients (89/150). The diagnostic accuracy rate for identifying constrictive pericarditis by echocardiography (98.7%, 107/109) was comparable to that of surgical diagnosis (100%, 109/109). Tuberculosis was the main cause of constrictive pericarditis in this cohort (78.7%, 118/150) including 25 (16.7%) cases with pathological or etiological evidences of tubercular pericarditis, 8 (5.3%) cases with pathologically active tuberculous focus elsewhere in the body, 66 (44.0%) cases with typical clinical tuberculosis manifestation and responded to anti-tubercular therapy and 19 (12.7%) cases with a diagnosis of suspicious tuberculosis. Pericardiectomy was performed in 108 cases and pericardial biopsy and surgical drainage was performed in 1 patient. In hospital death rate was 8.7% (13/150, 4 tubercular patients and 9 non-tubercular).

CONCLUSIONTuberculosis is the leading cause of constrictive pericarditis in this cohort and the best diagnosis tool is echocardiography other than pathological and etiological findings in pericardium.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; Pericarditis, Constrictive ; diagnosis ; etiology ; microbiology ; pathology ; Pericarditis, Tuberculous ; complications ; diagnosis ; pathology ; Retrospective Studies ; Young Adult

Eosinophilic myocarditis usually results from myocardial damage as a result of drugs or parasites, and is generally associated with increased peripheral eosinophil count. This form of myocarditis is difficult to diagnose clinically. A 25 year-old previously healthy woman was transferred from a local clinic because of hypotension and dyspnea with sudden cardiogenic shock after a three day history of gastrointestinal illness. Echocardiography revealed concentric left ventricular wall thickening with moderate pericardial effusion. Biopsy of endomyocardial tissue from the right ventricle showed diffuse infiltration of inflammatory cells, mostly eosinophils, even though the patient had a peripheral eosinophil count that was normal at the time of biopsy. The patient was treated with corticosteroids for the symptoms of pericarditis, and she recovered without cardiac sequelae, clinically and echocardiographically. We here report a case of acute eosinophilic myopericarditis, with cardiogenic shock, diagnosed by endomyocardial biopsy with normal peripheral eosinophil count at the time of biopsy, and complete recovery without sequelae.
Shock, Cardiogenic/blood/*etiology ; Pericarditis/blood/*diagnosis ; Myocarditis/blood/*diagnosis ; Leukocyte Count ; Humans ; Female ; *Eosinophils ; Eosinophilia/blood/*diagnosis ; Adult ; Acute Disease

The first thorny problem in the study of atrial fibrillation (AF) is the establishment of reliable animal models. This paper presents how to create a canine sterile pericarditis model. A new data analysis method, Fast Fourier Transform is introduced. The data from canine sterile pericarditis model was analyzed using FFT. The results demonstrate that canine sterile pericarditis model is a reliable animal model for studying AF and that FFT is a rapid and effective method for analyzing AF data.
Animals ; Atrial Fibrillation ; etiology ; Data Interpretation, Statistical ; Disease Models, Animal ; Dogs ; Electrocardiography ; Fourier Analysis ; Male ; Pericarditis ; complications ; Signal Processing, Computer-Assisted

In Singapore, 9.03 million doses of the mRNA COVID-19 vaccines by Pfizer-BioNTech and Moderna have been administered, and 4.46 million people are fully vaccinated. An additional 87,000 people have been vaccinated with vaccines in World Health Organization's Emergency Use Listing. The aim of this review is to explore the reported cardiac adverse events associated with different types of COVID-19 vaccines. A total of 42 studies that reported cardiac side effects after COVID-19 vaccination were included in this study. Reported COVID-19 vaccine-associated cardiac adverse events were mainly myocarditis and pericarditis, most commonly seen in adolescent and young adult male individuals after mRNA vaccination. Reports of other events such as acute myocardial infarction, arrhythmia and stress cardiomyopathy were rare. Outcomes of post-vaccine myocarditis and pericarditis were good. Given the good vaccine efficacy and the high number of cases of infection, hospitalisation and death that could potentially be prevented, COVID-19 vaccine remains of overall benefit, based on the current available data.
Adolescent ; Humans ; Male ; Young Adult ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; Myocarditis/etiology* ; Pericarditis ; RNA, Messenger ; Vaccination/adverse effects*

Adenocarcinoma ; surgery ; Candidiasis ; etiology ; Cardiac Tamponade ; diagnosis ; etiology ; Echocardiography ; Electrocardiography ; Esophageal Fistula ; complications ; diagnostic imaging ; Fever ; etiology ; Gastrectomy ; Haemophilus Infections ; etiology ; Heart Diseases ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pericardial Effusion ; diagnostic imaging ; etiology ; Pericarditis ; diagnostic imaging ; etiology ; Postoperative Complications ; diagnostic imaging ; Staphylococcal Infections ; etiology ; Stomach Neoplasms ; surgery ; Streptococcal Infections ; etiology ; Tomography, X-Ray Computed

INTRODUCTION: Despite reports suggesting an association between COVID-19 mRNA vaccination and pericarditis and myocarditis, detailed nationwide population-based data are sparsely available. We describe the incidence of pericarditis and myocarditis by age categories and sex after COVID-19 mRNA vaccination from a nationwide mass vaccination programme in Singapore. METHODS: The incidence of adjudicated cases of pericarditis and myocarditis following COVID-19 mRNA vaccination that were reported to the vaccine safety committee between January to July 2021 was compared with the background incidence of myocarditis in Singapore. RESULTS: As of end July 2021, a total of 34 cases were reported (9 pericarditis only, 14 myocarditis only, and 11 concomitant pericarditis and myocarditis) with 7,183,889 doses of COVID-19 mRNA vaccine administered. Of the 9 cases of pericarditis only, all were male except one. The highest incidence of pericarditis was in males aged 12-19 years with an incidence of 1.11 cases per 100,000 doses. Of the 25 cases of myocarditis, 80% (20 cases) were male and the median age was 23 years (range 12-55 years) with 16 cases after the second dose. A higher-than-expected number of cases were seen in males aged 12-19 and 20-29 years, with incidence rates of 3.72 and 0.98 case per 100,000 doses, respectively. CONCLUSION Data from the national registry in Singapore indicate an increased incidence of pericarditis and myocarditis in younger men after COVID-19 mRNA vaccination.
Adolescent ; Adult ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; Child ; Female ; Humans ; Male ; Middle Aged ; Myocarditis/etiology* ; Pericarditis/etiology* ; RNA, Messenger ; SARS-CoV-2 ; Vaccination/adverse effects* ; Vaccines, Synthetic ; Young Adult ; mRNA Vaccines