scholarly journals Effusive–constrictive pericarditis after the second dose of BNT162b2 vaccine (comirnaty): a case report

2022 ◽  
Author(s):  
Giacomo Maria Viani ◽  
Patrizia Pedrotti ◽  
Romano Seregni ◽  
Brucato Antonio
Keyword(s):  
Emergency Department ◽  
Adverse Reaction ◽  
Case Report ◽  
Inflammatory Response ◽  
Constrictive Pericarditis ◽  
Clinical Benefit ◽  
Natural Infection ◽  
Acute Pericarditis ◽  
Case Summary ◽  
Effusive Constrictive Pericarditis

Abstract Background Whereas effusive-constrictive pericarditis can rarely occur in COVID-19, to date no cases of effusive-constrictive pericarditis related to SARS-CoV2 vaccine have been documented. Case summary A 59-year-old caucasian man presented to our emergency department with effusive-constrictive pericarditis. Symptoms occurred shortly after the second dose of BNT162b2 (Comirnaty) vaccine. No other etiological causes were identified. Guidelines directed therapy for acute pericarditis was implemented, with clinical benefit. Discussion Systemic inflammatory response to COVID-19 can rarely trigger pericarditis. In our case a strong temporal relation between the second dose of BNT162b2 vaccine and symptoms occurrence was documented, indicating a possible rare adverse reaction to the vaccine, similarly to natural infection. Further research is needed to confirm a causal relationship.

scholarly journals 1095 Effective image-guided medical management in effusive constrictive pericarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Montes ◽  
A Cecconi ◽  
T Alvarado ◽  
A Vera ◽  
A Barrios ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Medical Treatment ◽  
Constrictive Pericarditis ◽  
Pericardial Fluid ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Intravenous Corticosteroid ◽  
Persistent Inflammation ◽  
High Doses ◽  
Effusive Constrictive Pericarditis

Abstract A 59 year old man was admited to hospitalization for persistent chest pain related to acute pericarditis. Within the admision tests, a transthoracic echography was performed, showing a moderate pericardial effusion with ventricular septal bounce and significant respiratory variations in mitral and tricuspid inflows, all of it consistent with effusive-constrictive pericarditis (Panel A). Anti-inflammatory treatment with ibuprofen and colchicine was started. During the first 48 hours of admission there was a clinical and hemodinamic worsening in the patient’s condition that forced the performance of a pericardial window, obtaining a very little quantity of dense pericardial fluid. Looking for a more accurate study of the pericardium, a cardiovascular magnetic resonance (CMR) was performed, revealing a thick heterogeneous pericardial effusion (Panel B) and a significant late gadolinium enhancement of both pericardial layers (Panel C). All these findings where consistent with an effusive constrictive pericarditis with persistent inflammatory activity despite high doses of conventional inflammatory treatment. Furthermore, the growth of Propionibacterium acnes in the pericardial fluid disclosed the etiology of this condition. Medical treatment was enhanced with high doses of intravenous corticosteroid, ceftriaxone and doxycycline. During the following days, the patient showed an excellent response achieving the complete clinical and echocardiographic relief of constrictive signs (Panel D). Effusive constrictive pericarditis is characterized by the presence of pericardial effusion and constriction secondary to an inflammatory process of the pericardium. Pericardiectomy might be necessary in case of failure of medical treatment, a very common scenario in this kind of .pericarditis. Our case is remarkable because it demonstrates the value of CMR to detect persistent inflammation of pericardium despite high doses of conventional medical treatment for pericaricarditis guiding the successful escalation to intravenous corticosteroid and avoiding the risk of an unnecessary cardiac surgery. Abstract 1095 Figure.

Pericardial diseases

2012 ◽  
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Tuberculous Pericarditis ◽  
Pericardial Diseases ◽  
Effusive Constrictive Pericarditis

Aetiology 460Syndromes of pericardial disease 461Acute pericarditis without effusion 461Pericardial effusion with or without tamponade 462Constrictive pericarditis 464Effusive-constrictive pericarditis 465Calcific pericarditis without constriction 465Viral pericarditis 466Tuberculous pericarditis 468Uraemic pericarditis 469Neoplastic pericardial disease 470Myxoedematous effusion ...

Abstract 13004: Spelunking for a Cause of Heart Failure: A Fungus Amongst Us

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nicholas S Hendren ◽  
Mark Berlacher ◽  
James A De Lemos
Keyword(s):  
Constrictive Pericarditis ◽  
Histoplasma Capsulatum ◽  
Mediastinal Lymph Node ◽  
Venous Pressure ◽  
Clinical History ◽  
The United States ◽  
Lymph Node Biopsy ◽  
Acute Pericarditis ◽  
Autoimmune Reaction ◽  
Effusive Constrictive Pericarditis

Two months prior to presenting to our facility, a 63-year-old man was diagnosed with acute pericarditis and treated with colchicine. His chest pain resolved, but he was readmitted a few weeks later with tamponade due to a large exudative pericardial effusion requiring percutaneous drainage. He was discharged on colchicine and furosemide; however, he presented to our institution two weeks later with persisting dyspnea and edema. His blood pressure was 114/84 mmHg without a pulsus paradoxus. Jugular venous pressure was 13 cm H 2 O with a prominent Kussmaul’s sign and 3+ bilateral leg edema. Further evaluation with a transthoracic echocardiogram, cardiac MRI and cardiac catheterization were all consistent with effusive-constrictive pericarditis (Fig A-F). 8-months prior to admission a mediastinal lymph node biopsy noted histoplasma. During admission, chronic histoplasmosis was suspected and a serum histoplasma antigen was reactive (1:256). He was initiated on 12 weeks of itraconazole; however, despite anti-inflammatory therapies, he had refractory congestion. Cardiothoracic surgery was consulted and he underwent pericardial stripping (Fig. G). Pericardial fungal cultures were negative and histopathology noted acute and chronic fibrinous pericarditis without fungal organisms (Fig. H-I). He had an uncomplicated recovery with symptom resolution. Histoplasma capsulatum is endemic to the United States and despite >80% of individuals in endemic areas demonstrating exposure, cases of pericarditis, tamponade or pericardial constriction are rare. Pericardial inflammation likely reflects an autoimmune reaction to H. capsulatum rather than direct pericardial infection and may respond to anti-inflammatories. In sum, we describe a rare diagnosis of effusive-constrictive pericarditis secondary to chronic histoplasmosis. Our case highlights the salient findings of pericardial constriction and the continued importance of a detailed clinical history.

scholarly journals Diagnosis and treatment of effusive–constrictive pericarditis: a case report

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Yousif Al-Saiegh ◽  
Jenna Spears ◽  
Tim Barry ◽  
Christopher Lee ◽  
Howard Haber ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Sleep Apnoea ◽  
Therapeutic Interventions ◽  
Right Atrial ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Obstructive Sleep ◽  
Obesity Hypertension ◽  
Effusive Constrictive Pericarditis

Abstract Background Effusive–constrictive pericarditis (ECP) is a rare syndrome involving pericardial effusion and concomitant constrictive pericarditis. The hallmark is a persistently elevated right atrial pressure of >10 mmHg or reduction of less than 50% from baseline despite pericardiocentesis. Aetiologies include radiation, infection, malignancy, and autoimmune disease. Case summary A 71-year-old man with a history of atrial fibrillation, obesity, hypertension, obstructive sleep apnoea, managed with continuous positive airway pressure presented with acute pericarditis complicated by pericardial effusion leading to cardiac tamponade. He was diagnosed with ECP after pericardiocentesis and was managed surgically with a pericardial window. Discussion Early detected cases of ECP can be managed by medical therapy. Therapeutic interventions include pericardiocentesis, balloon pericardiostomy, and pericardiectomy. This report describes a case of new-onset congestive heart failure secondary to ECP.

scholarly journals Idiopathic Effusive Constrictive Pericarditis Accompanying Multiple Complications: A Case Report

2020 ◽  
Author(s):  
Chaodi Luo ◽  
Jing Li ◽  
Yang Yan ◽  
Dan Han
Keyword(s):  
Case Report ◽  
Constrictive Pericarditis ◽  
Rare Case ◽  
Clinical Syndrome ◽  
Severe Tricuspid Regurgitation ◽  
Prognostic Predictor ◽  
Parietal Pericardium ◽  
Long Term Prognosis ◽  
Effusive Constrictive Pericarditis

Abstract IntroductionEffusive constrictive pericarditis (ECP) is a unique clinical syndrome that is characterized by the coexistence of pericardial effusion and constrictive pericardium. The etiology of ECP usually contains tuberculosis, idiopathic, and neoplastic causes. The early diagnosis, treatment strategy and prognostic predictor of ECP still remain a big problem nowadays due to the sophisticated clinical situations. Case PresentationWe here report a rare case of idiopathic ECP with thickened adherent visceral pericardium and normal parietal pericardium, accompanying multiple complications mainly comprising severe tricuspid regurgitation, hypoproteinemia, and proximal deep venous thrombosis. The patient was referred for radical pericardiectomy successfully, but the long-term prognosis may be unfavorable. DiscussionThis case aims to provide some clinical experience of such situation in which the clinician should weight the benefits and the risks to a particular patient.

scholarly journals Flecainide toxicity associated with the use of goji berries: a case report

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Carlos E Guzmán ◽  
Carla Gabriela Guzmán-Moreno ◽  
José Luis Assad-Morell ◽  
Edgar Francisco Carrizales-Sepúlveda
Keyword(s):  
Emergency Department ◽  
Drug Interaction ◽  
Case Report ◽  
Cardiovascular Diseases ◽  
Herbal Remedies ◽  
Herbal Supplement ◽  
Case Summary ◽  
Goji Berries ◽  
Favourable Evolution ◽  
Chronic Cardiovascular Diseases

Abstract Background Goji berries (GB), usually marketed as a ‘superfruit’, are a widely used herbal supplement. As with other herbal remedies, the use of GB might be associated with herb–drug interactions, increasing plasma levels of other drugs and causing adverse events. Here, we present the case of a patient that developed flecainide toxicity secondary to an herb–drug interaction, associated with the use of GB to prevent COVID-19. Case summary A 75-year-old female presented to the emergency department with fainting. She was taking flecainide for the treatment of atrial extrasystoles diagnosed 2 years previously, and she was using a tea of GB for the prevention of COVID-19. The admission electrocardiogram showed a wide complex polymorphic tachycardia that was considered and treated as flecainide toxicity. The patient had a favourable evolution and was discharged 48 h after admission. Discussion Flecainide toxicity is uncommon and needs timely recognition and treatment; it is usually secondary to overdose and renal or hepatic failure. In our case, toxicity was associated with GB use, probably by inhibition of CYP2D6 which is the main enzyme associated with the metabolism of flecainide. Clinicians need to be aware of the possible interactions between herbal remedies (in this case used for the prevention of COVID-19) and cardiovascular drugs that are used to treat chronic cardiovascular diseases.

scholarly journals An unusual interventricular septal bounce in a patient with dermatomyositis: a case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Vito Maurizio Parato ◽  
Davide Corradini ◽  
Andrea Di Matteo ◽  
Michele Scarano
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Cardiac Involvement ◽  
Transoesophageal Echocardiography ◽  
Jugular Veins ◽  
Acute Pericarditis ◽  
Case Summary ◽  
Almost All ◽  
First Time ◽  
Pericardial Involvement

AbstractBackgroundIn literature it has been reported in 1998, for the first time, a case of a 54-year-old man who developed constrictive pericarditis (CP) 12 years after diagnosis of dermatomyositis (DM). To our knowledge, this may be the only case reported.Case summaryA 16-year-old man presented to our institution because of symptoms posing a suspicion for an inflammatory disease; after physical examination, lab tests, and other investigations (electromyography, magnetic resonance, and muscular biopsy) was diagnosed as having DM. Patient also showed hepatomegaly and congested jugular veins: after clinical and imaging investigations (transthoracic echocardiography and transoesophageal echocardiography) he was diagnosed as having a CP. Patient underwent pericardial resection and the final outcome consisted of a completely regression of the symptoms.DiscussionCardiac involvement in patients with DM ranges between 6% and 75%, and it can be clinically manifest or, far more frequently, sub-clinic. Pericardial involvement as a complication of DM is widely reported in the literature, but in almost all cases as acute pericarditis, effusive pericarditis or cardiac tamponade and almost never as a CP.

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