A large pericardial effusion without haemodynamic compromise

The central tendon defect type of congenital diaphragmatic hernia (CDH) is extremely rare and usually associated with a significant pericardial effusion. Prenatal diagnostic ultrasound features of this quite rare entity remain often overlooked or misdiagnosed. There is a dearth of literature about the role of prenatal intervention, often through an elective pericardiocentesis, for the prevention of lung hypoplasia and to decrease the overall neonatal morbidity and mortality. To the best of our knowledge, till date, there is only one case that was subjected to a prenatal intervention. Here, we present a second case of a central tendon defect type of CDH with a large pericardial effusion that was subjected to a prenatal transthoracic pericardiocentesis. Although smooth intubation and ventilation were performed immediately after birth, the infant suffered for several months from respiratory instability. Laparoscopic central tendon hernia repair was performed, and neonate was discharged home at seven months of age. Although prenatal pericardiocentesis may facilitate smoother postnatal intubation and ventilation, its broader effect on respiratory function is uncertain and still remains elusive.

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US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis

Journal of the American Heart Association ◽

10.1161/jaha.120.018950 ◽

2021 ◽

Author(s):

Allan Klein ◽

Paul Cremer ◽

Apostolos Kontzias ◽

Muhammad Furqan ◽

Ryan Tubman ◽

...

Keyword(s):

Pericardial Effusion ◽

Cardiac Tamponade ◽

Treatment Response ◽

Constrictive Pericarditis ◽

Unmet Need ◽

Recurrent Pericarditis ◽

Pericardial Window ◽

Clinical Burden ◽

Large Pericardial Effusion ◽

Multiple Recurrences

Background Patients with recurrent pericarditis (RP) may develop complications, multiple recurrences, or inadequate treatment response. This study aimed to characterize disease burden and unmet needs in RP. Methods and Results This retrospective US database analysis included newly diagnosed patients with RP with ≥24 months of continuous history following their first pericarditis episode. RP was defined as ≥2 pericarditis episodes ≥28 days apart. Some patients had ≥2 recurrences, while others had a single recurrence with a serious complication, ie, constrictive pericarditis, cardiac tamponade, or a large pericardial effusion with pericardiocentesis/pericardial window. Among these patients with multiple recurrences and/or complications, some had features relating to treatment history, including long‐term corticosteroid use (corticosteroids started within 30 days of flare, continuing ≥90 consecutive days) or inadequate treatment response (pericarditis recurring despite corticosteroids and/or colchicine, or other drugs [excluding NSAIDs] within 30 days of flare, or prior pericardiectomy). Patients (N=2096) had hypertension (60%), cardiomegaly (9%), congestive heart failure (17%), atrial fibrillation (16%), autoimmune diseases (18%), diabetes mellitus (21%), renal disease (20%), anxiety (21%), and depression (14%). Complications included pericardial effusion (50%), cardiac tamponade (9%), and constrictive pericarditis (4%). Pharmacotherapy included colchicine (51%), NSAIDs (40%), and corticosteroids (30%), often in combination. This study estimates 37 000 US patients with RP; incidence was 6.0/100 000/year (95% CI, 5.6‒6.3), and prevalence was 11.2/100 000 (95% CI, 10.6‒11.7). Conclusions Patients with RP may have multiple recurrences and/or complications, often because of inadequate treatment response and persistent underlying disease. Corticosteroid use is frequent despite known side‐effect risks, potentially exacerbated by prevalent comorbidities. Substantial clinical burden and lack of effective treatments underscore the high unmet need.

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Pericardial effusion and constriction as an initial presentation of acute t-cell lymphoblastic lymphoma

The Southwest Respiratory and Critical Care Chronicles ◽

10.12746/swrccc.v7i28.541 ◽

2019 ◽

Vol 7 (28) ◽

pp. 28-32

Author(s):

Angela Rao ◽

Phumpattra Chariyawong ◽

Teerapat Nantsupawat ◽

Irfan Warraich ◽

Nandini Nair

Keyword(s):

T Cell ◽

Pericardial Effusion ◽

Clinical Manifestations ◽

Lymph Node Biopsy ◽

Lymphoblastic Lymphoma ◽

Large Pericardial Effusion ◽

Occult Malignancy ◽

Night Sweats ◽

Hodgkin's Lymphomas ◽

Late Manifestation

Acute T-cell lymphoblastic lymphoma is a rare subtype of non-Hodgkin’s lymphomaaccounting for 2% of adult non-Hodgkin’s lymphomas. Cardiac involvement in non-Hodgkin’slymphoma is usually a late manifestation, and pericardial effusion as an initial presentationis rare. We report a case of acute T-cell lymphoblastic lymphoma in a patient who initiallypresented with pericardial effusion. Diagnosis was difficult and challenging, as an infectiousetiology was first suspected. The patient presented with pericardial effusion without othercommon clinical manifestations of lymphoma, such as fever, night sweats, and weight loss. Hewas treated for constrictive pericarditis due to having positive Coxsackie B serology but hadno improvement with treatment. The pathology results of the pericardium after pericardiectomyreported fibrosis with a reactive lymphohistiocyte infiltrate. After CT scan revealed a largemediastinal mass, a lymph node biopsy was performed, and T-cell lymphoblastic lymphomawas confirmed. A detailed evaluation to search for occult malignancy should be considered inpatients who have persistent pericarditis that is unresponsive to anti-inflammatory therapy andin those who present with a new, large pericardial effusion or cardiac tamponade.

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Visceral Pericardial Lipoma Involving the Great Cardiac Vein with Large Pericardial Effusion

Anesthesia & Analgesia ◽

10.1213/ane.0b013e31826a0ffc ◽

2012 ◽

Vol 115 (6) ◽

pp. 1279-1281 ◽

Cited By ~ 1

Author(s):

Yosuke Kuzukawa ◽

Toshiyuki Sawai ◽

Junko Nakahira ◽

Masayuki Oka ◽

Yusuke Kusaka ◽

...

Keyword(s):

Pericardial Effusion ◽

Great Cardiac Vein ◽

Large Pericardial Effusion

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Capnocytophaga Induced Acute Necrotizing and Exudative Pericarditis with Abscess Formation

Case Reports in Infectious Diseases ◽

10.1155/2018/6437928 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Alexa Bello ◽

Alejandro Castaneda ◽

Abhay Vakil ◽

Joseph Varon ◽

Salim Surani

Keyword(s):

Pulmonary Embolism ◽

Pericardial Effusion ◽

Broad Spectrum ◽

Developed Countries ◽

Abscess Formation ◽

Pericardial Window ◽

Acute Pericarditis ◽

Large Pericardial Effusion ◽

Acute Necrotizing ◽

Pericardial Abscess

We present the case of a 55-year-old gentleman, with bilateral pulmonary embolism and a large pericardial effusion that lead to a pericardial window with evacuation of creamy pus. Gram stains were negative, with culture growing Capnocytophaga. Pathology revealed acute necrotizing and exudative changes, including frank abscess formation. In developed countries, pericardial abscess and acute pericarditis are uncommon due to availability of broad-spectrum antibiotics. Pericardial abscess due to Capnocytophaga is even more uncommon.

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