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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of herniation of the left atrial appendage, through a defect in the pericardium, is described in a 16-year-old boy who was below the third percentile for height and weight. The clinical presentation was an acute pericarditis. Widespread inversion of T waves on the electrocardiogram and collapse of the lower lobe of the left lung with pleural effusion developed. Thoracotomy showed strangulation of the atrial appendage which was excised, and the pericardial defect repaired. After operation there was a striking improvement in the electrocardiogram and a rapid gain in weight. Syndromes caused by pericardial defects are reviewed.
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PMID:Pericardial defect presenting as acute pericarditis. 111 66

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/mm(3). 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.
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PMID:Acute idiopathic hemorrhagic pericarditis with cardiac tamponade as the initial presentation of acquired immune deficiency syndrome. 2019 Oct 22

Acute pericarditis may result from many etiologies. Pericarditis as a complication of Epstein-Barr virus (EBV) infection is quite rare and is usually self-limited in immunocompetent patients. In particular, pericardial tamponade associated with EBV infection has been reported in only one case. An 18-year-old woman presented with chest pain and shortness of breath. Upon suspicion of pulmonary embolism, the patient was examined with computed tomography, which showed no pulmonary embolism, but massive pericardial fluid surrounding the whole pericardium. Transthoracic echocardiography revealed pericardial fluid collections in the posterolateral wall (3.5 cm), right ventricle (2 cm), and right atrium (1.4 cm), and a diastolic collapse of the right ventricular apical wall. Emergency pericardiocentesis was performed and a total of 750 ml fluid was removed, which resulted in hemodynamic improvement and disappearance of the diastolic collapse on echocardiography. Serum EBV VCA IgM and EBV PCR assays were found positive and medical therapy was instituted with the diagnosis of EBV-associated pericarditis. The patient showed complete improvement and was discharged. At one-month control, she was free of symptoms and her echocardiogram was normal.
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PMID:[Pericardial tamponade associated with Epstein-Barr virus in an immunocompetent young patient]. 2174 65

BACKGROUND In the modern antibiotic era, Streptococcus agalactiae infection of the endocardium and pericardial space is a rare occurrence. However, once the disease spreads it can lead to life-threatening illness despite advances in diagnostic and treatment modalities, partly because the symptoms and signs associated with pericarditis are frequently missing, and due to the rarity of the disease, diagnosis is often overlooked. We report an extremely rare case of purulent pericarditis caused by Streptococcus agalactiae. CASE REPORT A 65-year-old diabetic woman presented with generalized weakness, high-grade fever, and altered mental status. There were no signs or symptoms suggestive of cardiac tamponade on presentation. A computerized tomography (CT) scan of the chest showed a small pericardial effusion. She was managed for diabetic ketoacidosis and sepsis. An electrocardiogram was significant for new-onset atrial fibrillation. Her clinical status deteriorated rapidly as she developed acute hypoxic respiratory failure and shock. A bedside echocardiogram showed large pericardial effusion around the right ventricle and right ventricular diastolic collapse. She developed cardiac arrest, and during resuscitation bedside pericardiocentesis was done with drainage of 15 cc of serosanguineous fluid. However, the patient could not be revived. Subsequently, blood cultures grew Streptococcus agalactiae a day after she died. On autopsy, she was found to have findings of infective endocarditis and purulent pericarditis. CONCLUSIONS A high index of clinical suspicion is crucial when acute pericarditis is suspected, for early diagnosis and for timely initiation of appropriate therapy with antibiotics and aggressive pericardial drainage to prevent fatal outcome.
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PMID:Purulent Pericarditis: An Uncommon Presentation of a Common Organism. 2838 19