1/20. Pericardial heart disease: a study of its causes, consequences, and morphologic features.This report reviews morphologic aspects of pericardial heart disease. A morphologic classification for this condition is presented. An ideal classification of pericardial heart disease obviously would take into account clinical, etiologic and morphologic features of this condition but a single classification combining these three components is lacking. Pericardial heart disease is relatively uncommon clinically, and when present at necropsy it usually had not been recognized during life. The term "pericarditis" is inaccurate because most pericardial diseases are noninflammatory in nature. Morphologically chronic pericardial heart disease may present clinically as an acute illness. Even when clinical symptoms are present, however, few patients develop evidence of cardiac dysfunction (constriction). When pericardial constriction occurs, it is the result of increased pericardial fluid or increased pericardial tissue or both. Increased fluid is treated by drainage; increased tissue is treated by excision. In most patients with chronic constrictive pericarditis the etiology is not apparent even after histologic examination of pericardia.- - - - - - - - - - ranking = 1keywords = constriction (Clic here for more details about this article) |
2/20. cardiac tamponade in systemic lupus erythematosus. Report of four cases.OBJECTIVE: To report and assess the incidence of cardiac tamponade in systemic lupus erythematosus as a cardiac manifestation of the disease. methods: We reviewed the medical records of 325 patients diagnosed with systemic lupus erythematosus according to the American Rheumatism association and their complementary laboratory tests compatible with cardiac tamponade. RESULTS: In the 325 medical records reviewed, we found 108 patients with pericardial effusions corresponding to 33.2% of the total and 54% of the patients studied in the active phase of the disease. Clinical assessment and transthoracic echocardiogram allowed the clinical diagnosis of cardiac tamponade in only 4 (1.23%) patients, 3 of whom were females, white, with ages ranging from 25 to 44 years. The pericardial fluid was hemorrhagic or serosanguineous with high levels of FAN and positivity for LE cells. In the treatment, we successfully used pericardiocentesis associated with high doses of corticosteroids. In clinical and laboratory follow-up performed for a period of 3 years, neither recrudescence of the pericardial effusion nor evolution to constriction occurred. CONCLUSION: Even though rare (1.23%), cardiac tamponade in patients with systemic lupus erythematosus has a benign evolution when properly treated, according to our experience.- - - - - - - - - - ranking = 0.5keywords = constriction (Clic here for more details about this article) |
3/20. Clustering of recurrent pericarditis with effusion and constriction in a family.OBJECTIVE: To describe a cluster of cases of pericarditis in a midwestern family of German and Danish ancestry. patients AND methods: Retrospective review of available medical records identified 5 family members in 2 generations with confirmed diagnosis of pericarditis. RESULTS: Five family members, 3 males and 2 females, presented for medical evaluation of recurrent chest pain between 1969 and 1991. physical examination resulted in the diagnosis of pericarditis with effusive and constrictive features. The age at presentation ranged from 8 to 46 years. Despite extensive investigations, an idiopathic etiology was assigned to each case. In follow-up, all 5 family members had recurrent episodes of chest pain, self-limiting or responsive to medical therapy, but the effusive component remained a notable feature of the syndrome. CONCLUSIONS: diagnosis of pericarditis in 5 family members may represent the first description of familial clustering of isolated pericarditis. In addition, 3 other family members had symptoms of chest pain, but pericarditis remained undiagnosed. The aggregate history suggests autosomal dominant inheritance with incomplete penetrance.- - - - - - - - - - ranking = 2keywords = constriction (Clic here for more details about this article) |
4/20. Tuberculous pericarditis in an infant evolving during triple chemotherapy.A 36-month-old girl was treated for pulmonary tuberculosis (mycobacterium tuberculosis) with isoniazid, rifampin and pyrazinamide. Four weeks after starting chemotherapy, she developed high fever and clinical signs of acute pericardial tamponade. pericardial effusion was shown by echocardiography and subsequently removed by pericardiocentesis. M. tuberculosis was demonstrated in the pericardial fluid by microscopy, polymerase chain reaction and specific culture. After pericardial drainage, the actual therapy was extended to include streptomycin and prednisone. Follow-up examinations demonstrated complete recovery without signs of constrictive pericarditis. CONCLUSION: infants treated for tuberculosis should be followed closely in order to monitor not only side-effects of antituberculous drugs but also to detect early extrapulmonary spread that may occur even with adequate chemotherapy. Rapid intervention and treatment adjustment in infants with tuberculous pericarditis may prevent pericardial constriction and may lead to full recovery.- - - - - - - - - - ranking = 0.5keywords = constriction (Clic here for more details about this article) |
5/20. Coexistence of ductal constriction and closure of the foramen ovale in utero.We report a fetus with an unusual combination of a narrow ductus arteriosus (DA) and foramen ovale. A pregnant mother was referred at 26 weeks of gestation for fetal pericardial effusion. Fetal echocardiography showed pericardial effusion, right atrial enlargement, right ventricular hypertrophy, and tricuspid regurgitation. The DA looked tortuous with S-shaped kinking. The atrial septum primum bulged into the left atrium. color Doppler did not show any flow across the atrial septum. cesarean section was performed at 31 weeks of gestation. Admission to intensive care was required after delivery, but the infant gradually improved and was discharged home without any sequela.- - - - - - - - - - ranking = 2keywords = constriction (Clic here for more details about this article) |
6/20. Transient cardiac constriction following purulent pericarditis.Transient cardiac constriction is an unusual complication of purulent pericarditis. It should be suspected in the presence of clinical and haemodynamic deterioration when signs of activity have abated. Features of cardiac constriction were observed in a 4-year-old boy 2 weeks after surgical drainage. The patient was managed conservatively without surgery and the outcome was good. Follow up 2 years later showed a healthy boy with a normal cardiological examination.- - - - - - - - - - ranking = 3keywords = constriction (Clic here for more details about this article) |
7/20. Direct pericardial involvement of non-small cell lung cancer rapidly developing pericardial constriction.A 71-year-old male, who had been followed up after being treated with chemo-radiotherapy for non-small cell lung cancer (adenocarcinoma), rapidly developed dyspnea and mild fever. Radiographs showed left pleural effusion and cardiomegaly, and echocardiographic examination revealed echo-free space, suggesting a pericardial effusion. The patient was treated conservatively without any surgical procedures such as pericardiocentesis. Disappearance of the echo-free space was followed by development of pericardial constriction within two months. At post-mortem examination, a direct extension to the pericardium from the primary lesion of the right upper lobe through the mediastinum was observed. The rapid development of pericardial constriction is extremely rare in patients with malignant pericarditis.- - - - - - - - - - ranking = 3keywords = constriction (Clic here for more details about this article) |
8/20. Spontaneous tension hydropneumopericardium complicating serofibrinous pericarditis.A hydropneumopericardium is a rare but critical condition, which is mostly ascribed to primary infiltrative lesions from adjacent organs, pericardial infections, or trauma. Although there have been reports about pyopneumopericardium, no case of spontaneous non-purulent hydropneumopericardium has been documented in literature. We report a case of a previously healthy man of spontaneously occurred tension hydropneumopericardium complicating serofibrinous pericarditis. A surgical exploration followed by partial pericardiectomy was performed to stop cardiac tamponade and possible later constriction. Remarkably, no definite pathogenesis was identified despite surgical and laboratory investigations. The spontaneity and management of hydropneumopericardium are discussed.- - - - - - - - - - ranking = 0.5keywords = constriction (Clic here for more details about this article) |
9/20. indomethacin for preterm labor: fetal toxicity in a dizygotic twin gestation.indomethacin was given for the treatment of preterm labor in a twin pregnancy at a dosage of 200 mg/day for 7 days beginning at 34 weeks and 5 days' gestation. During treatment, one twin developed closure of the ductus arteriosus, tricuspid regurgitation, right ventricular dysfunction, and pericardial effusion. Severe oligohydramnios in both amniotic sacs appeared as well. All findings resolved within 7 days of discontinuation of the medication. The infants, delivered vaginally at 37 weeks' gestation, were alive and well at a 2-month follow-up visit. We believe that all fetuses of mothers treated with indomethacin should be closely monitored for early evidence of decreased amniotic fluid volume and constriction of the ductus arteriosus.- - - - - - - - - - ranking = 0.5keywords = constriction (Clic here for more details about this article) |
10/20. Constrictive epicarditis after open heart surgery: the turtle cage operation.A 60-year-old man developed constrictive epicarditis within 1 year after isolated mitral valve replacement (MVR). At reoperation, decortication of the thick epicardial layer resulted, impossible without a high risk of injury of the myocardium and major coronary arteries. Therefore, multiple longitudinal and transverse incisions were performed on the epicardial peel, which at the end acquired a turtle cage appearance allowing myocardial reexpansion, relief of constriction, and restoration of adequate hemodynamics.- - - - - - - - - - ranking = 0.5keywords = constriction (Clic here for more details about this article) |
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