1/22. The postpericardiotomy syndrome as a cause of pleurisy in rehabilitation patients.Pleuritic chest pain in patients on a rehabilitation unit may be caused by several conditions. We report 2 cases of postpericardiotomy syndrome (PPS) as a cause of pleuritic pain. PPS occurs in 10% to 40% of patients who have coronary bypass or valve replacement surgery. The syndrome is characterized by fever, chest pain, and a pericardial or pleural friction rub. Its etiology is believed to be viral or immunologic. The syndrome can be a diagnostic challenge, and an increase in length of hospitalization because of it has been documented. Identified risk factors for PPS include age, use of prednisone, and a history of pericarditis. A higher incidence has been reported from May through July. Many patients undergo a battery of expensive procedures before PPS is diagnosed. The pain is sharp, associated with deep inspiration, and changes with position. Pleural effusions may be present and tend to occur bilaterally. Pericardial effusions are a documented complication. A pericardial or pleural rub may be present and is often transient. Serial auscultation is important. Laboratory work provides clues with a mild leukocytosis and an elevated erythrocyte sedimentation rate. However, this does not provide the definitive diagnosis. Cardiac enzymes are not reliably related to the syndrome. An electrocardiogram will show changes similar to those associated with pericarditis. The patient may have a fever, but it is rarely higher than 102.5 degrees F. Complications include pericardial effusions, arrhythmias, premature bypass graft closure, and cardiac tamponade. Treatment consists of a 10-day course of nonsteroidal anti-inflammatory drugs.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
2/22. Drug induced chest pain-rare but important.pericarditis, usually viral in origin, is an infrequent cause of chest pain. pericarditis due to drug allergy is even less frequent and is thus rarely considered in the differential diagnosis. A case is reported of a woman who presented with severe chest pain, caused by minocycline induced pericarditis. Such allergy may be more common than reported. It is suggested that drug induced pericarditis should be included in the differential diagnosis of acute chest pain.- - - - - - - - - - ranking = 1keywords = pericarditis (Clic here for more details about this article) |
3/22. nocardia asteroides pericarditis in association with hiv.This case report describes Nocardia pericarditis in a newly diagnosed human immunodeficiency virus (hiv) patient as an initial manifestation. Previously, two cases of Nocardia pericarditis were reported in patients with established hiv infection. To our knowledge this is the first case of Nocardia pericarditis as an initial manifestation of hiv infection. This case substantiates and emphasizes the importance of identifying Nocardia as an infectious cause of pericarditis in patients with acquired immunodeficiency. Long-term survival may be achieved with a combined medical and surgical approach.- - - - - - - - - - ranking = 4keywords = pericarditis (Clic here for more details about this article) |
4/22. Acute pleuritic chest pain.BACKGROUND: The differential diagnosis of acute pleuritic chest pain is large and includes a number of life threatening conditions. Clinical suspicion plays a major role in the choice of investigation and the interpretation of the results. OBJECTIVE: To outline the clinical features and diagnostic workup of three acute causes of pleuritic chest pain--acute pulmonary embolism, pneumothorax and acute pericarditis. DISCUSSION: The general practitioner plays an important role in the initiation of the investigative pathway for these conditions. Appropriate referral for ongoing assessment and care requires the primary care physician to be aware of the available investigations and their limitations.- - - - - - - - - - ranking = 0.5keywords = pericarditis (Clic here for more details about this article) |
5/22. Possible mesalamine-induced pericarditis: case report and literature review.pericarditis should be considered in any patient complaining of chest pain and/or dyspnea who is taking a product that contains mesalamine or sulfasalazine. A 41-year-old woman was taking mesalamine 800 mg 3 times/day for 3 weeks before hospital admission. She complained of sharp, pleuritic chest pain that radiated down both arms and increased in intensity when lying down. She was diagnosed with pericarditis based on clinical presentation and electrocardiogram findings. Differential diagnoses for myocardial infarction, systemic lupus erythematosus, and viral or bacterial causes were ruled out based on subjective and objective data. mesalamine-induced pericarditis was considered on hospital day 2, and the drug was discontinued at discharge on day 3. Clinicians should be aware of this potential drug-related complication, as the relationship between mesalamine or sulfasalazine and pericarditis has been reported rarely in the literature.- - - - - - - - - - ranking = 3.5keywords = pericarditis (Clic here for more details about this article) |
6/22. Electrocardiographic T-wave inversion: differential diagnosis in the chest pain patient.Inverted T waves produced by myocardial ischemia are classically narrow and symmetric. T-wave inversion (TWI) associated with an acute coronary syndrome (ACS) is morphologically characterized by an isoelectric ST segment that is usually bowed upward (ie, concave) and followed by a sharp symmetric downstroke. The terms coronary T wave and coved T wave have been used to describe these ischemic TWIs. Prominent, deeply inverted, and widely splayed T waves are more characteristic of non-ACS conditions such as juvenile T-wave patterns, left ventricular hypertrophy, acute myocarditis, wolff-parkinson-white syndrome, acute pulmonary embolism, cerebrovascular accident, bundle branch block, and later stages of pericarditis.- - - - - - - - - - ranking = 0.5keywords = pericarditis (Clic here for more details about this article) |
7/22. acute coronary syndrome in patients with human immunodeficiency virus disease.With more effective prophylactic treatment and an increased time of survival, noninfectious conditions associated with human immunodeficiency virus (hiv) disease are being recognized with increasing frequency in hiv patients. Cardiac involvement in hiv-infected patients varies from clinically silent to a fatal disease with a direct cardiac cause of mortality estimated at 1% to 6%. pericardial effusion, pericarditis, myocarditis, cardiomyopathy, endocarditis, and pulmonary hypertension are known cardiac manifestations associated with hiv infection. coronary artery disease (CAD) has not been a recognized complication of hiv disease, although some recent case reports have suggested occurrence of premature CAD and accelerated atherogenesis in hiv-infected patients. The role of protease inhibitors have been suggested in the development of this complication. After reviewing records of the last 7 years, the authors found 10 cases of acute coronary syndrome in hiv-infected patients who had no other risk factor for CAD except smoking. The presence of CAD was confirmed by angiography or autopsy. The mean CD4 count was 380 cells/mm3, and the mean duration between the diagnosis of hiv infection and CAD was 7.5 years. Four patients had single-vessel disease, 1 patient had 2-vessel disease, and 5 patients had 3-vessel disease. Three patients underwent coronary bypass surgery and 1 patient died of cardiogenic shock. CAD may be associated with hiv disease.- - - - - - - - - - ranking = 0.5keywords = pericarditis (Clic here for more details about this article) |
8/22. ST. segment elevation: is it a possible infarct?In patients with acute substernal pain seen at Emergency Departments, ST segment elevations are considered the hallmark of an acute myocardial infarct. Acute substernal pain associated with ST segment elevations is the inclusion criteria for thrombolytic therapy. However, there are other conditions, which may present with ST segment elevation in which thrombolytic therapy is not indicated. Acute pericarditis and ECG variants of normal must also be considered in the differential diagnosis. Three cases are presented that illustrate this ECG presentation. It is of paramount importance, that the Emergency Department physician who does the triage for these patients be able to identify the various causes of ST segment elevation.- - - - - - - - - - ranking = 0.5keywords = pericarditis (Clic here for more details about this article) |
9/22. guillain-barre syndrome coexisting with pericarditis or nephrotic syndrome after influenza vaccination.A 68-year-old woman and a 72-year-old man presented with distal weakness of the limbs and numbness following an influenza vaccination within 2 weeks. Moreover, guillain-barre syndrome (GBS) was diagnosed in two patients. pericarditis was diagnosed in the first patient who also had precordial chest pain with referral to trapezius ridge, and nephrotic syndrome, was observed in the second patient who had leg edema and proteinuria. The relationship among GBS, pericarditis and nephrotic syndrome after an influenza vaccination is discussed.- - - - - - - - - - ranking = 2.5keywords = pericarditis (Clic here for more details about this article) |
10/22. Localized pericardial inflammation in systemic lupus erythematosus.Regional or localized pericarditis has been infrequently reported. We report a patient with systemic lupus erythematosus (SLE), who presented with retrosternal pleuritic-type chest pain without audible friction rub, electrocardiographic changes or detectable pericardial effusion on echocardiography. Computed tomography, however, revealed a circumscribed area of pericardial inflammation, suggesting a diagnosis of localized lupus-associated pericarditis. This case demonstrates that localized pericarditis may occur in SLE and that chest CT may be required as part of the work-up in the diagnosis of lupus pericarditis.- - - - - - - - - - ranking = 2keywords = pericarditis (Clic here for more details about this article) |
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