Assuntos
Lúpus Eritematoso Sistêmico/complicações , Pericardite Constritiva/etiologia , Anti-Inflamatórios/uso terapêutico , Dispneia/etiologia , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Pericardiectomia , Pericardite Constritiva/diagnóstico por imagem , Pericardite Constritiva/fisiopatologia , Pericardite Constritiva/cirurgia , Derrame Pleural/etiologia , Índice de Gravidade de Doença , Esteroides/uso terapêutico , Resultado do TratamentoRESUMO
An 85-year-old man with cardiac history notable for atrial fibrillation diagnosed 10 years ago which was being treated with atenolol and warfarin presented to our institution with persistent atrial fibrillation. His echocardiogram showed ejection fraction (EF) of 56%, no regional wall motion abnormalities, mild mitral and pulmonary regurgitation, and trivial tricuspid regurgitation. Despite this treatment, he had recurrent episodes of paroxysmal symptomatic atrial fibrillation with a rapid rate requiring multiple emergency department visits and hospital admissions. Given difficulty to control the rate, he underwent atrioventricular (AV) nodal ablation and leadless pacemaker insertion. Fifteen days after the procedure, he was found to have a severe mitral regurgitation murmur.