ABSTRACT
BACKGROUND: In the livestock industry, Foreign Body Syndrome is a devastating disease condition. Feeding management, lacking of food discrimination, and eating chopped food increase the risk of swallowing sharp foreign bodies in bovine species. In addition to the honeycomb cells shape of the reticulum, the contractions of the reticular wall, gravid uterine pressure, and parturition efforts, foreign bodies can penetrate the reticular wall, causing cascade of problems including traumatic reticulitis, traumatic reticuloperitonitis, and traumatic pericarditis. The present study was carried out to evaluate the diagnostic significance of cardiac troponin I rapid test cassette and other cardiac biomarkers including serum cardiac troponin I (cTn I), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase enzyme (AST), in confirmed cases of traumatic pericarditis (TP) and/or traumatic reticuleoperitonitis (TRP) in cattle and buffaloes. METHODS: A total number of 30 animals (22 cattle and 8 buffaloes) with different signs such as anorexia, jugular distension, brisket edema, and signs of pain (reluctance to move, arching back, and abduction of the forelimbs) were included in the present study. Based on case history, clinical signs, ferroscopic, pericardiocentesis, radiographic and ultrasonographic examinations, TP were confirmed in cattle (n = 10) and buffaloes (n = 8) while TRP were confirmed only in cattle (n = 12). Additionally, 20 clinically healthy animals (n = 10 cattle and 10 buffaloes) were used as a control group. Blood samples were collected for determination of blood level of Tn-I, and activity of CK-MB, LDH, and AST. RESULTS: The obtained results revealed a highly significant increase in serum cTn I in diseased cattle with TP and TRP (P = 0.00), while buffaloes with TP showed no significant changes in serum cTn I (P = 0.111). Both diseased cattle and buffaloes showed increased serum activities of CK-MB, AST, and LDH enzyme. On the other hand, cardiac troponin I rapid test cassette failed to detect cTn I in diseased animals. CONCLUSION: The study concluded that the cardiac troponin I rapid test cassette did not have a diagnostic significance and could not be used as a point-of-care under field condition for diagnosis of TP and TRP in large ruminants. However, the serum troponin I level is helpful in diagnosis of TP and TRP in cattle. Although cardiac biomarkers have some diagnostic values in TP and TRP, the traditional diagnostic methods (clinical, radiography and ultrasonography examinations) are crucial for thorough evaluation of TP/TRP cases in bovine.
Subject(s)
Biomarkers , Buffaloes , Cattle Diseases , Creatine Kinase, MB Form , Pericarditis , Reticulum , Troponin I , Animals , Pericarditis/veterinary , Pericarditis/diagnosis , Pericarditis/blood , Cattle , Biomarkers/blood , Troponin I/blood , Cattle Diseases/diagnosis , Cattle Diseases/blood , Creatine Kinase, MB Form/blood , Female , Peritonitis/veterinary , Peritonitis/diagnosis , Peritonitis/blood , L-Lactate Dehydrogenase/blood , Aspartate Aminotransferases/blood , Male , Foreign Bodies/veterinary , Foreign Bodies/complications , Foreign Bodies/diagnosisABSTRACT
BACKGROUND Cryptococcosis is an invasive fungal infection caused by Cryptococcus species complex. C. neoformans is one of the pathogenic species within the genus. C. neoformans infections often present as an opportunistic infection in severely immunocompromised individuals. Infection of the pericardium in the setting of liver failure is uncommon. We present a case of cryptococcal pericarditis in a patient with liver failure. CASE REPORT A 47-year-old man with a past medical history of psoriatic arthritis, and alcohol use disorder presented to the emergency department with a 2-week history of progressively worsening generalized weakness, malaise, and yellowish skin changes. Physical examination revealed scleral icterus, jaundiced skin, and ascites. Initial laboratory workup revealed thrombocytopenia, transaminitis (aspartate transaminase (AST) level of 502 IU/L, alanine transaminase (ALT) level of 82 IU/L), hyperbilirubinemia (total bilirubin of 15.7 mg/dL), International Nationalized Ratio (INR) of 3.6, and lactic acidosis (lactic acid of 11.7 mmol/L). The patient developed encephalopathy and acute hypoxic respiratory failure requiring intubation. A bedside point-of-care cardiac ultrasound, performed following intubation, revealed a pericardial effusion without signs of tamponade. This finding was later confirmed by a formal transthoracic echocardiogram. Percutaneous pericardiocentesis was performed, and the pericardial fluid culture revealed the presence of C. neoformans. Human immunodeficiency virus (HIV) tests were negative. The patient received antifungal therapy. Due to his poor prognosis, he was transitioned to comfort care and eventually died. CONCLUSIONS This case report describes an unusual presentation of acute liver failure complicated by cryptococcal pericarditis, emphasizing the importance of considering atypical fungal infections in such patients.
Subject(s)
Cryptococcosis , Pericarditis , Humans , Male , Middle Aged , Cryptococcosis/diagnosis , Cryptococcosis/complications , Pericarditis/microbiology , Pericarditis/diagnosis , Liver Failure/etiology , Cryptococcus neoformans/isolation & purification , Antifungal Agents/therapeutic use , Immunocompromised Host , Fatal OutcomeABSTRACT
Acute pericarditis is defined as inflammation of the pericardium and occurs in approximately 4.4% of patients who present to the emergency department for nonischemic chest pain, with a higher prevalence in men. Although there are numerous etiologies of pericarditis, most episodes are idiopathic and the cause is presumed to be viral. Diagnosis of pericarditis requires at least two of the following criteria: new or worsening pericardial effusion, characteristic pleuritic chest pain, pericardial friction rub, or electrocardiographic changes, including new, widespread ST elevations or PR depressions. Pericardial friction rubs are highly specific but transient, and they have been reported in 18% to 84% of patients with acute pericarditis. Classic electrocardiographic findings include PR-segment depressions; diffuse, concave, upward ST-segment elevations without reciprocal changes; and T-wave inversions. Transthoracic echocardiography should be performed in all patients with acute pericarditis to characterize the size of effusions and evaluate for complications. Nonsteroidal anti-inflammatory drugs are the first-line treatment option. Glucocorticoids should be reserved for patients with contraindications to first-line therapy and those who are pregnant beyond 20 weeks' gestation or have other systemic inflammatory conditions. Colchicine should be used in combination with first- or second-line treatments to reduce the risk of recurrence. Patients with a higher risk of complications should be admitted to the hospital for further workup and treatment.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal , Electrocardiography , Pericarditis , Humans , Pericarditis/diagnosis , Pericarditis/physiopathology , Pericarditis/therapy , Acute Disease , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Colchicine/therapeutic use , Echocardiography , Female , Pericardial Effusion/diagnosis , Pericardial Effusion/therapy , Pericardial Effusion/etiology , Chest Pain/etiology , Chest Pain/diagnosis , Male , Glucocorticoids/therapeutic useABSTRACT
INTRODUCTION: Purulent pericarditis secondary to esophago-pericardial fistula is a serious complication that has been previously reported in patients with esophageal cancer treated with radio/chemotherapy and esophageal stenting. However, the presence of esophago-pericardial fistula as the first manifestation of advanced carcinoma of the esophagus is exceedingly infrequent. We report the case of a 61-year-old male who presented with sepsis, cardiac tamponade and septic shock who was found to have an esophago-pericardial fistula secondary to squamous carcinoma of the esophagus. Emergency pericardiocentesis was performed with subsequent hemodynamic improvement. The drained pericardial fluid was purulent in nature and cultures were positive for Streptococcus anginosus. A CT scan followed by upper gastrointestinal endoscopy with tissue biopsy confirmed the diagnosis of squamous cell carcinoma of the esophagus. A self-expanding covered stent was endoscopically placed to exclude the fistula and restore the esophageal lumen. In this report, we discuss some aspects related to the diagnosis and management of this serious clinical entity.
Subject(s)
Carcinoma, Squamous Cell , Esophageal Fistula , Esophageal Neoplasms , Pericarditis , Humans , Male , Middle Aged , Esophageal Neoplasms/pathology , Esophageal Neoplasms/complications , Pericarditis/microbiology , Pericarditis/etiology , Pericarditis/therapy , Pericarditis/diagnosis , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Esophageal Fistula/etiology , Esophageal Fistula/diagnosis , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Streptococcus anginosus/isolation & purification , Pericardiocentesis , Stents , Tomography, X-Ray Computed , Cardiac Tamponade/etiologyABSTRACT
Pericarditis is a well-known complication of hypothyroidism. Although pericarditis and pericardial effusions have been reported as rare complications of hyperthyroidism in adults, they are rarely reported in the pediatric population. In this case report, we describe a 12-year-old, previously healthy girl with nighttime chest pain, dyspnea, tachycardia, and abnormal thyroid function studies consistent with hyperthyroidism who was found to have pericarditis and pericardial effusion requiring pericardiocentesis.
Subject(s)
Graves Disease , Pericardial Effusion , Humans , Pericardial Effusion/etiology , Pericardial Effusion/diagnostic imaging , Female , Graves Disease/complications , Graves Disease/diagnosis , Child , Pericardiocentesis , Pericarditis/etiology , Pericarditis/diagnosis , Pericarditis/complicationsABSTRACT
Inflammatory disease of the pericardium represents a relatively common presentation, especially among the young. For the most part, inflammatory pericardial disease can be expeditiously and effectively managed without significant sequelae. However, some individuals present with severe and recurrent illness, representing significant therapeutic challenges. During the past decade, there have been great strides made in developing an evidence-based approach to management of inflammatory pericardial disease, the result of which has been the development of (1) a systematic, protocoled approach to initial care; (2) targeted therapeutics; and (3) specialized, collaborative, and integrated care pathways. Herein we present a review of the current state of the art as it pertains to the diagnostic evaluation and therapeutic considerations in inflammatory pericardial disease with a focus on acute and complicated pericarditis.
Subject(s)
Pericarditis , Humans , Pericarditis/diagnosis , Pericarditis/therapy , Pericarditis/etiology , Acute DiseaseABSTRACT
A 55-year-old male with acute pericarditis presented with low-pressure cardiac tamponade (LPCT) unresponsive to volume infusion. Subsequent pericardiocentesis resulted in hemodynamic improvement and unmasking of pericardial constriction. This case provides illustrative hemodynamic tracings of LPCT. Additionally, the presence of concurrent pericardial constriction that may indicate a plausible underlying mechanism for the blunted responsiveness to fluid expansion in LPCT. The underlying physiologic processes and the associated hemodynamic tracings are discussed.
Subject(s)
Cardiac Tamponade , Hemodynamics , Pericardiocentesis , Humans , Cardiac Tamponade/physiopathology , Cardiac Tamponade/etiology , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/surgery , Male , Middle Aged , Treatment Outcome , Pericarditis/physiopathology , Pericarditis/therapy , Pericarditis/diagnostic imaging , Pericarditis/etiology , Pericarditis/diagnosis , Acute DiseaseABSTRACT
Medical therapy of pericarditis should be targeted at its aetiology. Unfortunately, many cases of pericarditis remain idiopathic after a complete diagnostic workup. In such cases, empiric anti-inflammatory therapy for pericarditis is aimed at controlling symptoms and preventing recurrences. The aim of the present clinical review is to summarize published evidence, guidelines, and to provide tips and tricks for clinical management of acute and recurrent pericarditis.
Subject(s)
Pericarditis , Humans , Pericarditis/drug therapy , Pericarditis/therapy , Pericarditis/diagnosis , Anti-Inflammatory Agents/therapeutic use , Recurrence , Practice Guidelines as Topic , Treatment Outcome , Secondary Prevention/methodsABSTRACT
INTRODUCTION: Postoperative atrial fibrillation (POAF) is common following open heart surgery, and is associated with significant morbidity. Medications used for ventricular rate control of POAF may not be effective in controlling rapid ventricular rates during the postoperative period because of increased sympathetic tone. The purpose of this study was to develop nonpharmacologic rate control of POAF by atrioventricular node (AVN) fat pad stimulation using clinically available temporary pacing wires in the canine sterile pericarditis model. METHODS: We studied 10 sterile pericarditis dogs in the closed-chest state on postoperative days 1-3. The AVN fat pad stimulation (amplitude 2-15 mA; frequency 20 Hz; pulse width 0.03-0.2 ms) was performed during sustained POAF (>5 min). We measured ventricular rate and inefficient ventricular contractions during sustained POAF and compared it with and without AVN fat pad stimulation. Also, the parameters of AVN fat pad stimulation to achieve a rate control of POAF were measured over the postoperative days. RESULTS: Eleven episodes of sustained POAF were induced in 5/10 sterile pericarditis dogs in the closed-chest state on postoperative days 1-2. During POAF, the AVN fat pad stimulation decreased the ventricular rate from 178 ± 52 bpm to 100 ± 8 bpm in nine episodes. Nonpharmacologic rate control therapy successfully controlled the ventricular rate and eliminated inefficient ventricular contractions during POAF for the duration of the AVN fat pad stimulation. The AVN fat pad stimulation output remained relatively stable over the postoperative days. CONCLUSION: During sustained POAF, nonpharmacologic rate control by AVN fat pad stimulation effectively and safely controlled rapid ventricular rates throughout the postoperative period.
Subject(s)
Atrial Fibrillation , Disease Models, Animal , Heart Rate , Pericarditis , Animals , Dogs , Atrial Fibrillation/physiopathology , Atrial Fibrillation/diagnosis , Pericarditis/physiopathology , Pericarditis/diagnosis , Cardiac Pacing, Artificial , Atrioventricular Node/physiopathology , Atrioventricular Node/surgery , Male , Time Factors , Cardiac Surgical Procedures/adverse effects , Adipose Tissue/physiopathology , Postoperative Complications/etiologyABSTRACT
BACKGROUND: Purulent pericarditis (PP)- a purulent infection involving the pericardial space-requires a high index of suspicion for diagnosis as it often lacks characteristic signs of pericarditis and carries a mortality rate as high as 40% even with treatment. Common risk factors include immunosuppression, diabetes mellitus, thoracic surgery, malignancy, and uremia. Most reported cases of PP occur in individuals with predisposing risk factors, such as immunosuppression, and result from more commonly observed preceding infections, such as pneumonia, osteomyelitis, and meningitis. We report a case of PP due to asymptomatic bacteriuria in a previously immunocompetent individual on a short course of high-dose steroids. CASE PRESENTATION: An 81-year-old male presented for severe epigastric pain that worsened with inspiration. He had been on high-dose prednisone for presumed inflammatory hip pain. History was notable for urinary retention requiring intermittent self-catheterization and asymptomatic bacteriuria and urinary tract infections due to methicillin-sensitive Staphylococcus aureus (MSSA). During the index admission he was found to have a moderate pericardial effusion. Pericardial fluid cultures grew MSSA that had an identical antibiogram to that of the urine cultures. A diagnosis of purulent pericarditis was made. CONCLUSION: PP requires a high index of suspicion, especially in hosts with atypical risk factors. This is the second case of PP occurring as a result of asymptomatic MSSA bacteriuria. Through reporting this case we hope to highlight the importance of early recognition of PP and the clinical implications of asymptomatic MSSA bacteriuria in the setting of urinary instrumentation and steroid use.
Subject(s)
Bacteriuria , Mediastinitis , Pericardial Effusion , Pericarditis , Sclerosis , Staphylococcal Infections , Male , Humans , Aged, 80 and over , Methicillin/therapeutic use , Staphylococcus aureus , Bacteriuria/complications , Bacteriuria/pathology , Pericardium/pathology , Pericarditis/diagnosis , Pericarditis/drug therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Pericardial Effusion/therapy , Pericardial Effusion/drug therapy , PainABSTRACT
AIM: Anakinra, an anti IL-1 agent targeting IL-1 alfa and beta, is available for the treatment of recurrent pericarditis in cases with corticosteroid dependence and colchicine resistance after failure of conventional therapies. However, it is unclear if the combination with colchicine, a non-specific inhibitor of the inflammasome targeting the same inflammatory pathway of IL-1, could provide additional benefit to prevent further recurrences. The aim of the present observational study is to assess whether the addition of colchicine on top of anakinra could prolong the time to first recurrence and prevent recurrences better than anakinra alone. METHODS: International, all-comers, multicentre, retrospective observational cohort study analysing all consecutive patients treated with anakinra for corticosteroid-dependent and colchicine-resistant recurrent pericarditis. The efficacy endpoint was recurrence rate and the time to the first recurrence. RESULTS: A total of 256 patients (mean age 45.0±15.4 years, 65.6% females, 80.9% with idiopathic/viral aetiology) were included. 64 (25.0%) were treated with anakinra as monotherapy while 192 (75.0%) with both anakinra and colchicine. After a follow-up of 12 months, 56 (21.9%) patients had recurrences. Patients treated with colchicine added to anakinra had a lower incidence of recurrences (respectively, 18.8% vs 31.3%; p=0.036) and a longer event-free survival (p=0.025). In multivariable analysis, colchicine use prevented recurrences (HR 0.52, 95% CI 0.29 to 0.91; p=0.021). CONCLUSIONS: The addition of colchicine on top of anakinra treatment could be helpful to reduce recurrences and prolong the recurrence-free survival.
Subject(s)
Interleukin 1 Receptor Antagonist Protein , Pericarditis , Female , Humans , Adult , Middle Aged , Male , Interleukin 1 Receptor Antagonist Protein/adverse effects , Retrospective Studies , Colchicine/adverse effects , Adrenal Cortex Hormones , Pericarditis/diagnosis , Pericarditis/drug therapy , Pericarditis/chemically induced , Interleukin-1ABSTRACT
INTRODUCTION: Psoriasis is a chronic skin condition characterized by hyperproliferation of epidermal keratinocytes, resulting in erythematous and scaling lesions. The US Food and Drug Administration (FDA) has approved nine biologic agents to address the burden of psoriasis, but their cardiovascular risks remain poorly studied. METHODS: This retrospective pharmacovigilance study utilized the FDA Adverse Event Reporting System (FAERS) database to analyze adverse events associated with newly approved therapeutic agents for psoriasis. We employed disproportionally signal analysis, calculating the reporting odds ratio (ROR) with a 95% confidence interval. RESULTS: Among the vast FAERS database, which contained >25 million adverse events, a total of 334,399 events were associated with newly approved therapeutic agents for psoriasis. Cardiac adverse events accounted for 3852 cases, including pericarditis, atrial fibrillation, and coronary artery disease. Secukinumab had the highest number of reported adverse events, followed by brodalumab, while tildrakizumab had the lowest. Coronary artery disease was the most reported adverse event (1438 cases), followed by pericarditis (572 cases) and atrial fibrillation (384 cases). Secukinumab had the highest incidence of coronary artery disease, pericarditis, and atrial fibrillation. Risankizumab was significantly associated with an increased risk of coronary artery disease and atrial fibrillation, while tildrakizumab and Ixekizumab were associated with atrial fibrillation. Secukinumab was associated with an elevated risk of pericarditis. CONCLUSIONS: The study uncovers the cardiovascular adverse effects related to biologic agents used in psoriasis treatment. These findings emphasize the importance of monitoring and evaluating the cardiovascular safety profiles of biological agents used in psoriasis treatment.
Subject(s)
Atrial Fibrillation , Biological Products , Coronary Artery Disease , Pericarditis , Psoriasis , Humans , United States/epidemiology , Cardiotoxicity/epidemiology , Atrial Fibrillation/diagnosis , Atrial Fibrillation/drug therapy , Atrial Fibrillation/epidemiology , Retrospective Studies , Psoriasis/chemically induced , Psoriasis/diagnosis , Psoriasis/drug therapy , Pharmacovigilance , Pericarditis/chemically induced , Pericarditis/diagnosis , Pericarditis/epidemiology , Biological Products/therapeutic use , United States Food and Drug AdministrationABSTRACT
Pericarditis typically presents with classic symptoms of acute sharp, retrosternal, and pleuritic chest pain. It can have several different underlying causes including viral, bacterial, and autoimmune etiologies. The mainstays of pericarditis treatment are nonsteroidal anti-inflammatory drugs and colchicine with glucocorticoids or other immunosuppressive drugs used for refractory cases and relapse. Myocarditis is an inflammatory disease of the cardiac muscle that is caused by a variety of infectious and noninfectious conditions. It mainly affects young adults (median age 30-45 years), and men more than women. The clinical manifestations of myocarditis are highly variable, so a high level of suspicion in the early stage of disease is important to facilitate diagnosis. The treatment of myocarditis includes nonspecific treatment aimed at complications such as heart failure and arrhythmia, as well as specific treatment aimed at underlying causes. Pericarditis and myocarditis associated with vaccine have been extremely rare before coronavirus disease 2019 (COVID-19). There is a small increase of incidence after COVID-19 messenger ribonucleic acid vaccine, but the relative risk for pericarditis and myocarditis due to severe acute respiratory syndrome coronavirus 2 infection is much higher. Therefore, vaccination against COVID-19 is currently recommended for everyone aged 6 years and older.
Subject(s)
COVID-19 , Myocarditis , Pericarditis , Male , Young Adult , Humans , Female , Adult , Middle Aged , Myocarditis/diagnosis , Myocarditis/therapy , Affect , COVID-19 Vaccines , Pericarditis/diagnosis , Pericarditis/therapy , VaccinationSubject(s)
Cardiac Tamponade , Fistula , Mediastinitis , Pericarditis , Sclerosis , Humans , Pericardium , Pericarditis/complications , Pericarditis/diagnosis , Fistula/complications , Fistula/diagnosis , Fistula/surgeryABSTRACT
A description of a COVID-19 patient with the development of exudative pericarditis complicated by cardiac tamponade is provid. A peculiarity of this case is the presence of an underlying disease in the patient (chronic lymphocytic leukemia), which was in remission for 1.5 years after chemotherapy. Another feature of the patient was the relatively small area of lung damage and the hemorrhagic nature of the pericardial effusion, which persisted for a long time. The insignificant activity of inflammatory markers was noteworthy. Possible mechanisms of development and features of the course of exudative pericarditis in the described patient, issues of diagnosis and treatment of this category of patients are discusse.
Subject(s)
COVID-19 , Cardiac Tamponade , Pericardial Effusion , Pericarditis , Humans , COVID-19/complications , COVID-19/diagnosis , Pericarditis/diagnosis , Pericarditis/etiology , Pericarditis/therapy , Pericardial Effusion/diagnosis , Pericardial Effusion/etiology , Pericardial Effusion/therapy , Cardiac Tamponade/diagnosis , Cardiac Tamponade/etiology , Cardiac Tamponade/therapyABSTRACT
Background: COVID-19 disease (coronavirus disease 2019) has multiple potentially fatal cardiovascular complications and pericarditis is one of them; however, if prompt treatment is given, fatal events associated to this complication decrease. Its frequency and presentation characteristics are unknown, which is why its early diagnosis is important. Objective: To know the frequency of pericarditis secondary to COVID-19 and its presentation characteristics. Material and methods: Cross-sectional study in patients with a diagnosis of pericarditis after COVID-19 disease (with a positive test). Symptoms, age, sex, comorbidities, and electrocardiogram (ECG) and transthoracic echocardiogram (TTE) results were obtained. Results: A total of 3364 patients positive for COVID-19 were registered, out of which 10 met criteria for pericarditis, which represented a frequency of 0.30%. The average age of the sample was 46.1 years and 60% predominated in the male gender with a 1.5:1 ratio. The most frequent clinical characteristics were the presence of retrosternal pain (90%), absence of comorbidity (50%), and absence of electrocardiographic changes (40%). Conclusions: Pericarditis has a low frequency in patients with COVID-19. The predominant clinical presentation is chest pain. Almost half will not have electrocardiographic changes, and half will not have comorbidities.
Introducción: la enfermedad COVID-19 (coronavirus disease 2019) tiene múltiples complicaciones cardiovasculares potencialmente mortales y la pericarditis es una de ellas; sin embargo, si se da un tratamiento oportuno disminuyen sus eventos fatales. Se desconoce su frecuencia y características de presentación, por lo que es importante su diagnóstico temprano. Objetivo: conocer la frecuencia de pericarditis secundaria a COVID-19 y sus características de presentación. Material y métodos: estudio transversal en pacientes con diagnóstico de pericarditis posterior a la enfermedad COVID-19 (con prueba positiva). Se obtuvo la sintomatología, edad, sexo, comorbilidades y resultados de electrocardiograma (ECG) y ecocardiograma transtorácico (ETT). Resultados: se registraron 3364 pacientes positivos a COVID-19, de los cuales 10 cumplieron con criterios para pericarditis, lo que representó una frecuencia del 0.30%. La edad promedio de la muestra fue de 46.1 años y predominó en el género masculino (60%) con una relación 1.5:1. Las características clínicas más frecuentes fueron la presencia de dolor retroesternal (90 %), ausencia de comorbilidad (50 %) y ausencia de cambios electrocardiográficos (40%). Conclusiones: la pericarditis tiene una frecuencia baja en pacientes con COVID-19. La presentación clínica predominante es el dolor retroesternal. Casi la mitad no tendrá cambios electrocardiográficos y la mitad no tendrá comorbilidades.
Subject(s)
COVID-19 , Pericarditis , Humans , Male , Middle Aged , SARS-CoV-2 , COVID-19/complications , Cross-Sectional Studies , Pericarditis/diagnosis , Pericarditis/epidemiology , Pericarditis/etiology , ElectrocardiographyABSTRACT
Histoplasma-mediated pericarditis is rare, and it occurs due to host-mediated inflammatory or immune response to adjacent mediastinal adenitis or pneumonitis. It is usually self-limited and rarely progresses to a disseminated infection in an immunocompetent individual. In rare instances, it can occur without pulmonary manifestations, making the diagnosis challenging given the broad list of differentials that can be considered as in our patient who initially presented with an isolated pericardial effusion with tamponade needing emergent pericardiocentesis.
Subject(s)
Cardiac Tamponade , Pericardial Effusion , Pericarditis , Humans , Child , Cardiac Tamponade/etiology , Cardiac Tamponade/complications , Histoplasma , Pericardial Effusion/etiology , Pericardial Effusion/complications , Pericardiocentesis , Pericarditis/complications , Pericarditis/diagnosisABSTRACT
BACKGROUND: Candida pericardial infection is a rare clinical entity usually related to recent cardiothoracic surgery and chronic debilitating conditions. During the COVID-19 pandemic, invasive fungal infections have been on the rise, likely due to a combination of factors such as immunosuppression, underlying conditions like diabetes, and surgical procedures. CASE PRESENTATION: Herein, we report a 67-year-old diabetic woman with a history of COVID-19 infection who received a high dose of corticosteroids a few months before admission, and previous myocardial infarction for more than 12 years. The patient had a positive cardiac tamponade with signs of dyspnea, chest pain, and low blood pressure. Echocardiographic data were more in favor of constrictive pericarditis. The patient underwent urgent echocardiography-guided pericardiocentesis and then broad-spectrum antibiotic treatment was prescribed. Repeated echocardiography implied a persistent pericardial effusion 10 days later. Subxiphoid aspirates and biopsied tissues showed budding yeast cells and yeast colonies grew on culture media identified as Candida albicans. CONCLUSION: This report should bring to the attention of physicians toward the possibility of Candida pericardial infection presenting with cardiac tamponade after COVID-19 infection and cardiothoracic surgery. Echocardiographic assessment, prompt pericardiotomy, molecular-based identification of causative agent, and early administration of appropriate antifungal treatment should improve the patient's survival.
Subject(s)
COVID-19 , Candidiasis , Cardiac Tamponade , Pericarditis , Female , Humans , Aged , Cardiac Tamponade/etiology , Cardiac Tamponade/diagnosis , Cardiac Tamponade/surgery , Candida albicans , Pandemics , COVID-19/complications , Candidiasis/complications , Pericarditis/complications , Pericarditis/diagnosis , Pericarditis/microbiologyABSTRACT
INTRODUCTION: Smartwatches, wrist-mounted devices with computing capacity able to connect with other devices via short-range wireless networking, are today commonly used by the general population to monitor their health status using specific applications. Currently, these devices offer new possibilities in remote health care monitoring and integration with other applications, through alert notifications, collection of personal data by a variety of sensors and the storage of these data. Several companies are introducing smartwatches with "health status" monitoring software with multiple functions, i.e. electrocardiogram (ECG) sensors. Recently, detection of atrial fibrillation based on heart rate monitoring by optical sensors resulted to be feasible and reliable when using the Apple Watch® and its corresponding application. Indeed, previous case reports highlighted its sensitivity in detecting morphological changes typical of the Acute Coronary Syndrome. CASE REPORT: We report the case of a healthcare worker, who experienced chest pain and diffuse myalgia, detected ECG alterations in the ST segment, and reached the Emergency Department Myopericarditis was diagnosed and treated promptly to prevent complications. DISCUSSION: Acute viral myocarditis and pericarditis are clinical conditions, usually characterized by 21 a benign course that does not require medical evaluation. However, ventricular arrhythmias are also common in viral myocarditis, and the latter is associated with a large proportion of sudden cardiac deaths in the young population without previous structural heart disease. In this case report, smartwatch technology allowed the preventive implementation of interventions against potentially life-threatening complications. Further developments in smartwatch technology could lead to more sensitive and specific diagnostic algorithms for conditions that require immediate medical intervention.