Salmonella: a rare cause of subacute effusive-constrictive pericarditis

A 36 year old woman had emergency pericardectomy because of subacute effusive-constrictive pericarditis. The pericardial fluid and tissue culture showed that this was caused by infection with Salmonella enteritidis. Cardiac involvement with salmonella does not usually present in such an aggressive manner and it has not previously been reported to cause this rare type of cardiac constriction.     

Reversible subacute effusive-constrictive pericarditis after correction of double-chambered right ventricle: a case report

A 15-year-old girl developed subacute constrictive pericarditis following successful surgical repair of double-chambered right ventricle. Two weeks after surgery, the patient had massive pericardial effusion, which acutely progressed to constrictive pericarditis with the symptoms of cardiac tamponade. Further surgery was necessary to resect the parietal pericardium. No blood transfusion was required for this patient, who was a Jehovah's Witness. She was doing well 9 months after the second operation, with residual pericardium of normal thickness.     

Salmonella: a rare cause of subacute effusive-constrictive pericarditis.

A 36 year old woman had emergency pericardectomy because of subacute effusive-constrictive pericarditis. The pericardial fluid and tissue culture showed that this was caused by infection with Salmonella enteritidis. Cardiac involvement with salmonella does not usually present in such an aggressive manner and it has not previously been reported to cause this rare type of cardiac constriction.     

Tuberculous effusive-constrictive pericarditis

Infection with Mycobacterium tuberculosis and the human immunodeficiency virus has reached epidemic proportions in South Africa. Cardiac involvement occurs in approximately one per cent of patients suffering from active tuberculosis. This concerns predominantly pericardial involvement, resulting in chronic pericardial effusions, cardiac tamponade and constrictive pericarditis. Effusive-constrictive pericarditis is a clinical haemodynamic syndrome in which constriction by the visceral pericardium occurs in the presence of a tense effusion in a free pericardial space. We present a patient who was diagnosed with this condition, and highlight the value of contrast-enhanced magnetic resonance imaging in demonstrating the underlying structural and functional abnormalities.     

Transient effusive-constrictive pericarditis due to chemotherapy

Commonly used chemotherapeutic agents, specifically cytarabine and daunorubicin, can cause effusive-constrictive pericarditis. We describe a case of transient effusive-constrictive pericarditis in a patient with acute myelogenous leukemia. This is the first case report of a patient with transient effusive-constrictive pericarditis due to chemotherapy.     

Primary malignant pericardial mesothelioma presenting as effusive-constrictive pericarditis

Effusive-constrictive pericarditis is a clinical hemodynamic syndrome characterized by constriction of the heart by the visceral pericardium in the presence of a tense pericardial effusion. The hallmark of effusive-constrictive pericarditis is the persistence of elevated right atrial pressures and ventricular interdependence after relief of the elevated intrapericardial pressures. The present report discusses the unique case of a 46-year-old white female who presented with dyspnea on exertion and chest tightness in the setting of an effusive-constrictive pericarditis. The patient was subsequently diagnosed with primary malignant pericardial mesothelioma, an extremely rare neoplasm with a very poor prognosis.     

A case of subacute effusive constrictive pericarditis with a probable amoebic aetiology

A 48 year old man with amoebic pericarditis did not improve after pericardiocentesis. Facilities for echocardiography and haemodynamic studies were not available. Cardiac compression was suspected and at emergency pericardiectomy subacute effusive constrictive amoebic pericarditis was found. The patient recovered. This is believed to be the first report of a case of subacute effusive constrictive pericarditis caused by amoebiasis.     

Presentation pattern and management of effusive-constrictive pericarditis in Ibadan

Background: Effusive-constrictive pericarditis is a syndrome in which constriction by the visceral pericardium occurs in the presence of a dense effusion in a free pericardial space. Treatment of this disease is problematic because pericardiocentesis does not relieve the impaired filling of the heart and surgical removal of the visceral pericardium is challenging. We sought to provide further information by addressing the evolution and clinico-pathological pattern, and optimal surgical management of this disease. Methods: We conducted a prospective review of a consecutive series of five patients managed in the cardiothoracic surgery unit of University College Hospital, Ibadan, in the previous year, along with a general overview of other cases managed over a seven-year period. This was followed by an extensive literature review with a special focus on Africa. Results: The diagnosis of effusive-constrictive pericarditis was established on the basis of clinical findings of features of pericardial disease with evidence of pericardial effusion, and echocardiographic finding of constrictive physiology with or without radiological evidence of pericardial calcification. A review of our surgical records over the previous seven years revealed a prevalence of 13% among patients with pericardial disease of any type (11/86), 22% of patients presenting with effusive pericardial disease (11/50) and 35% who had had pericardiectomy for constrictive pericarditis (11/31). All five cases in this series were confirmed by a clinical scenario of non-resolving cardiac impairment despite adequate open pericardial drainage. They all improved following pericardiectomy. Conclusion: Effusive-constrictive pericarditis as a subset of pericardial disease deserves closer study and individualisation of treatment. Evaluating patients suspected of having the disease affords clinicians the opportunity to integrate clinical features and non-invasive investigations with or without findings at pericardiostomy, to derive a management plan tailored to each patient. The limited number of patients in this series called for caution in generalisation. Hence our aim was to increase the sensitivity of others to issues raised and help spur on further collaborative studies to lay down guidelines with an African perspective.     

A case of subacute effusive constrictive pericarditis with a probable amoebic aetiology.

A 48 year old man with amoebic pericarditis did not improve after pericardiocentesis. Facilities for echocardiography and haemodynamic studies were not available. Cardiac compression was suspected and at emergency pericardiectomy subacute effusive constrictive amoebic pericarditis was found. The patient recovered. This is believed to be the first report of a case of subacute effusive constrictive pericarditis caused by amoebiasis.     

A case of microscopic polyangitis presented with acute pericarditis]

We report a case of microscopic polyangitis presenting with acute pericarditis. A 75-year-old man, who had recurrent acute pericarditis, was referred by a cardiologist because of bilateral infiltrates in the chest radiograph, microhematuria and progressive renal failure. The test for MPO-ANCA was positive. Transbronchial and renal biopsies were compatible with microscopic polyangitis, showing alveolar hemorrhage and crescentic glomerulonephritis. After 3 days, intravenous methylpredonisolone was given, followed by oral prednisolone 40 mg/day, and the patient's radiographic infiltrates cleared and renal dysfunction improved. However, he died from opportunistic infection 109 days after the onset of treatment.     

A case of tuberculous pericarditis developing constrictive pericarditis

A case of constrictive pericarditis which developed after the onset of clinical manifestation of tuberculous pericarditis was reported. A 75-year-old male, complaining of anorexia, was admitted to our hospital. Adenosinedeaminase (ADA) level in pericardial effusion was found to be increased, and the culture of pericardial effusion was positive for tubercle bacilli. Diagnosed as having tuberculous pleuritis and pericarditis, he underwent chemotherapy for tuberculosis. However, massive pleural effusion developed later and pleural effusion drainage was carried out. Despite repeated drainage, pleural effusion continued to recur. Chest CT revealed apparent pericardial thickening, in addition, cardiac catheterization revealed elevation of mean right atrial pressure and marked deterioration of cardiac functions including decrease of cardiac output. These findings were compatible with constrictive pericarditis. After these investigations a diagnosis of constrictive pericarditis was established, and the patient underwent a pericardiectomy. Pathological examination of resected specimens revealed tuberculous inflammation.     

A case of tuberculous pericarditis

A case of tuberculous pericarditis successfully managed with medical treatment alone was reported. A 78-year-old male was admitted because of cough, dyspnea and fever. Chest X-P and echocardiogram revealed massive pericardial effusion. His clinical symptoms and signs suggested cardiac tamponade. Mycobacterium tuberculosis was detected from pericardial fluid. ADA activity in pericardial fluid was high. Thoracic CT scan showed tracheobronchial, pretracheal, paratracheal and superior mediastinal lymph-node swelling. The diagnosis of tuberculous pericarditis was confirmed. Anti-tuberculous therapy consisting of INH, RFP, EB in combination with prednisolone was started. One month later pericardial effusion was controlled and six months later he was in good clinical condition without surgical treatment.     

Management of a patient with active rheumatoid arthritis and suspected tuberculosis causing effusive-constrictive pericarditis

In the following case report we present a patient who has been admitted for pericardial effusion causing cardiac compression with active rheumatoid arthritis and suspected tuberculosis. The patient was successfully treated with intravenous pulse steroid for active rheumatoid arthritis, with prophylactic anti-tuberculosis agents for suspected tuberculosis and with surgical pericardiectomy for the thickened pericardium as well as recurrent pericardial effusion.