Humans ; COVID-19/complications* ; Pericarditis/complications*

Adult ; Anti-Inflammatory Agents ; therapeutic use ; Coronary Vasospasm ; complications ; physiopathology ; Coronary Vessels ; diagnostic imaging ; Electrocardiography ; Gas Gangrene ; complications ; therapy ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Male ; Pericarditis ; complications ; physiopathology

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

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

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

Acute myopericarditis is usually caused by viral infections, and the most common cause of viral myopericarditis is coxsackieviruses. Diagnosis of myopericarditis is made based on clinical manifestations of myocardial (such as myocardial dysfunction and elevated serum cardiac enzyme levels) and pericardial (such as inflammatory pericardial effusion) involvement. Although endomyocardial biopsy is the gold standard for the confirmation of viral infection, serologic tests can be helpful. Conservative management is the mainstay of treatment in acute myopericarditis. We report here a case of a 24-year-old man with acute myopericarditis who presented with transient effusive-constrictive pericarditis. Echocardiography showed transient pericardial effusion with constrictive physiology and global regional wall motion abnormalities of the left ventricle. The patient also had an elevated serum troponin I level. A computed tomogram of the chest showed pericardial and pleural effusion, which resolved after 2 weeks of supportive treatment. Serologic testing revealed coxsackievirus A4 and B3 coinfection. The patient received conservative medical treatment, including nonsteroidal anti-inflammatory drugs, and he recovered completely with no complications.
Acute Disease ; *Coinfection ; Coxsackievirus Infections/complications/diagnosis/therapy/*virology ; Echocardiography, Doppler ; Electrocardiography ; Enterovirus A, Human/*isolation & purification ; Enterovirus B, Human/*isolation & purification ; Humans ; Male ; Myocarditis/diagnosis/therapy/*virology ; Pericardial Effusion/diagnosis/therapy/*virology ; Pericarditis, Constrictive/diagnosis/therapy/*virology ; Pleural Effusion/diagnosis/therapy/*virology ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

We present a case of inadvertent arterial insertion of a central venous catheter, identified during a pericardiectomy procedure after observing abrupt changes in pressure waveform and confirmed via arterial blood gas analysis and transesophageal echocardiography. Central venous pressure measurement was initially 20 mmHg in supine, and then elevated to 30-40 mmHg in right lateral decubitus, presumably resulting from constrictive physiology of pericarditis. The pressure waveforms, however, abruptly changed from a venous to an arterial waveform during surgery. When visual discrimination between arterial and venous blood regurgitation is unreliable, anesthesiologists should confirm that using all the available methods one has on the scene, especially after at least two unsuccessful attempts or in patients with advanced age or clinical conditions resulting in jugular venous dilation. To prevent arterial catheterization, one should limit the leftward rotation of the head by <40degrees and consider using ultrasound-guided method after more than two unsuccessful attempts.
Blood Gas Analysis ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Central Venous Pressure ; Discrimination (Psychology) ; Echocardiography, Transesophageal ; Head ; Humans ; Intraoperative Complications ; Pericardiectomy ; Pericarditis

This paper presents a case of cardiac tamponade with idiopathic hemorrhagic pericarditis as the initial symptom of human immunodeficiency virus (HIV) infection. A 29-year-old male came to the emergency room with a sudden onset of dizziness. Upon arrival, he was hypotensive although not tachycardic, and his jugular venous pressure was not elevated. His chest X-rays revealed a mild cardiomegaly. Transthoracic echocardiography revealed a large amount of pericardial effusion with a diastolic collapse of the right ventricle, a dilated inferior vena cava with little change in respiration, and exaggerated respiratory variation of mitral inflow velocities, representing echocardiographic evidence of cardiac tamponade. After pericardiocentesis, his blood pressure improved to 110/70 mmHg without inotropics support. Serial 12-lead electrocardiograms during hospitalization revealed upwardly concave diffuse ST-segment elevation followed by a T-wave inversion suggestive of acute pericarditis. Pericardial fluid cytology and cultures for bacteria, mycobacteria, adenovirus, and fungus were all negative. HIV enzyme-linked immunosorbent assay (ELISA) was positive and confirmed by Western blot. The CD4 cell count was 168/mm3. Finally, the diagnosis of cardiac tamponade due to HIV-associated hemorrhagic pericarditis was made. It was concluded that HIV infection should be considered in the diagnosis of unexplained pericardial effusion or cardiac tamponade in Korea.
Acquired Immunodeficiency Syndrome/*diagnosis/*pathology ; Acute Disease ; Adult ; Cardiac Tamponade/*complications/*diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Male ; Pericarditis/*complications/*diagnosis

OBJECTIVETo summarize the experience with surgical treatment of constrictive pericarditis.

METHODSA retrospective analysis of the post-operative clinical data was conducted in 128 surgical patients with chronic constrictive pericarditis.

RESULTSTwo early postoperative death occurred in this group due to severe low cardiac output syndrome, with the mortality rate of 1.57%. The postoperative complications included low cardiac output syndrome (13.2%), arrhythmia (7.02%), acute renal insufficiency (3.9%), respiratory insufficiency (3.1%), wound infection (2.3%), postoperative chest bleeding (1.6%) and cerebral infarction (0.78%). Relapse occurred in one case because of incomplete pericardial resection.

CONCLUSIONSConstrictive pericarditis should be confirmed as soon as possible with actively surgery, and the extent of pericardial resection should be decided according to the individual conditions. Complete untethering of the diseased pericardium should be performed with active prevention of postoperative complications.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Pericarditis, Constrictive ; surgery ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Treatment Outcome ; Young Adult

Although it is a rare complication of cardiac surgery, constrictive pericarditis still remains a difficult problem that needs an appropriate treatment after cardiac surgery. We had two patients with constrictive pericarditis presenting with unexplained right heart failure early after cardiac surgery, and the diagnosis of constrictive pericarditis was made by a specific finding of septal bounce shown in echocardiographic study. On the postoperative 40th day and 31st day, they underwent pericardiectomy by a left limited anterolateral thoracotomy. For one to two weeks since pericardiectomy, the cardiac failure symptoms were gradually relieved. For patients without improvement of the constrictive symptom and sign even with conservative medical therapy for constrictive pericarditis developed early after cardiac surgery, pericardiectomy by a left limited anterolateral thoracotomy is considered as a useful therapeutic mode.
Heart Failure ; Humans ; Pericardiectomy ; Pericarditis, Constrictive ; Postoperative Complications ; Thoracic Surgery ; Thoracotomy