Acute Pericarditis: Descriptive Study and Etiology Determination in a Predominantly African American Population.

INTRODUCTION ---Acute pericarditis is the most commonly encountered manifestation of pericardial disease (incidence: 0.2 percent to 0.5 percent in hospitalized patients). However, data regarding manifestations, workup, and the management of acute pericarditis in the African American population is lacking. This study aims to collect and analyze more clinical data related to acute pericarditis in this understudied population. METHODOLOGY We conducted a retrospective chart review of all patients managed for acute pericarditis at a university hospital serving a predominantly African American population. A total of 78 charts were reviewed during the period of study from January 2011 to July 2016. Out of these, nine charts were excluded due to poor data. We descriptively analyzed data regarding presenting symptoms, underlying etiologies, co-morbidities, investigation results, management strategies, and prognoses. RESULTS We found an equal number of males and females in our study population. The most common comorbid conditions were hypertension, chronic kidney disease, and diabetes mellitus (in order of incidence). The most common presentation of symptomatic pericarditis consisted of chest pain, dyspnea, tachycardia, and tachypnea. Electrocardiogram (EKG) findings included diffuse ST elevation (15 percent) and sinus tachycardia (41 percent). Leukocytosis was seen in 15 percent of the patients. The most common etiology noted in our patient population was idiopathic and was treated with NSAIDS. CONCLUSION As compared to other populations, the incidence of uremic pericarditis and pericarditis secondary to cardiac etiologies is slightly higher in the African American population; however, the clinical presentation, examination and laboratory findings, as well as investigations, are remarkably similar.

Rhabdomyolysis and dengue Fever: a case report and literature review.

The medical literature contains only a few reports of rhabdomyolysis occurring in patients with dengue fever. We report the case of a 25-year-old Jamaican man who was admitted to a private hospital four days after the onset of an acute febrile illness with fever, myalgia, and generalized weakness. Dengue fever was confirmed with a positive test for the dengue antigen, nonstructural protein 1. He remained well and was discharged on day 6 of his illness. On day 8, he started to pass red urine and was subsequently admitted to the University Hospital of the West Indies. On admission he was found to have myoglobinuria and an elevated creatine phosphokinase (CPK) of 325,600 U/L, leading to a diagnosis of rhabdomyolysis. Dengue IgM was positive. He was treated with aggressive hydration and had close monitoring of his urine output, creatinine, and CPK levels. His hospital course was uneventful without the development of acute renal failure and he was discharged after 14 days in hospital, with a CPK level of 2463 U/L. This case highlights that severe rhabdomyolysis may occur in patients with dengue fever and that early and aggressive treatment may prevent severe complications such as acute renal failure and death.