Acute pericardial diverticulum caused by pericarditis treated with drainage of pericardial effusion.

A 50-year-old woman was admitted with congestive heart failure due to cardiac tamponade, which was caused by acute pericarditis with pericardial effusion. Although images of contrast computed tomography (CT) obtained two weeks prior to admission had shown no abnormality, CT on admission showed a mediastinal tumor communicating with the pericardial cavity. It had rapidly appeared in a few weeks. We diagnosed it as acute pericardial diverticulum caused by acute pericarditis. They improved after treatment with antibiotic therapy and pericardial drainage. .

Myocardial infarction in a premenopausal woman with a decreased serum estrogen level due to leuprorelin acetate.

A 45-year-old premenopausal woman was admitted with acute myocardial infarction. Her serum estrogen level was decreased because of leuprorelin acetate administration, 3 months prior to admission for the treatment of uterine myoma. Emergency coronary angiography revealed diffuse narrowing of the distal half of the left anterior descending artery (LAD). The second coronary angiography after anti-anginal medication revealed significant improvement in LAD narrowing, which suggested prolonged coronary vasospasm. She had no coronary risk factors except for a positive family history. This case suggests that a decreased serum estrogen level could cause ischemic heart disease even in premenopausal women.