• Title/Summary/Keyword: Pericarditis

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Surgical Treatment of Chronic Constrictive Pericarditis -Report of 4 ases- (만성 교약성 심낭염의 외과적 치료 -4례 보고-)

  • 전희재
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.793-797
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    • 1994
  • Constrictive pericarditis is often accompanied with ~brothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective symptoms. We experienced 4 cases of constrictive pericarditis combined with bilateral ~brothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time through anterolateral thoracotomy with sternal transection[3 patients] and median sternotomy incision[l patient]. Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive retraction for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right atrium, SVC and IVC.

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Clinical review of four patients of acute purulent pericarditis (급성 화농성 심낭염의 외과적 고찰)

  • Kim, Su-Seong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.263-268
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    • 1984
  • Four patients of acute purulent pericarditis were seen at the Jeonbug National University Hospital between January, 1979 and December 1983. All patients were proven to have acute purulent pericarditis by clinical evaluation, bacterial study, and biopsy. Three patients were male and one female. The three patients were in pediatric age. The primary focuses were meningitis, Rt. coxitis, lobar pneumonia, and gastro-enteritis. The causative organisms were staphylococcus aureus in two patients. In the other two patients, organisms were not cultured from the pericardial pus. The reason why the causative organisms were not cultured in pericardial pus was probably due to massive antimicrobial treatment before pus collection. All patients were treated with systemic antibiotic therapy and pericardiostomy with normal saline irrigation. The three patients were treated without specific complication. The one patient developed the chronic constrictive pericarditis. In this patient, pericardiectomy was performed.

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The Surgical Treatment of Chronic Constrictive Pericarditis -A Report of 35 Cases- (만성교약성 심낭염의 외과적 요법 -35예 보고-)

  • 김주현
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.179-188
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    • 1974
  • An analysis of &5 cases of constrictive pericarditis treated surgically in this department of Seoul National University Hospital between the years 1958 and 1974 has been presented. 1.Of the patients with constrictive pericarditis,29 were males and 6 were females. Their ages averaged 23.8 years. 2. All patients who had pericardiectomy showed excellent postoperative results, and no operative mortality was noted in this group of patients but 3 hospital death [9.1%] occurred. 3. Besides shortening of circulation time elevated venous pressure was restored to normal range after pericardiectomy from a preoperative average 25.8cm $H_2O$ to a postoperative average 14.8cm $H_2O$. 4. Electrocardiographic changes consisted chiefly of low voltage complexes, P-wave and T-wave changes and characterized by vertical or semivertical heart position. The ECG was returned to normal or near normal after Pericardiectomy. 5. There were seven postoperative complications in this series. 6. In ten cases [32.3%], the pathology revealed evidence of tuberculosis in the pericardium or the myocardium, and others were described as chronic, proliferative, fibrous pericarditis or hyalinization of the pericardium.

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Surgical Treatment of Chronic Constrictive Pericarditis (만성 교약성 심낭염의 외과적 치료)

  • Jang, Bong-Hyeon;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.317-322
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    • 1987
  • Records of 15 patients who underwent operation for constrictive pericarditis at this department from 1976 through 1984 were reviewed. All had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. There were 12 males and 3 females in this series. Range of age varied from 7 years to 51 years. Clinical and histological study revealed granulomatous pericarditis compatible with the diagnosis of tuberculosis in 5 patients, non-specific chronic inflammatory changes in 6 patients and pyogenic pericarditis in 2 patients. Pericardiectomy was performed through a median sternotomy [11 cases] or bilateral anterior thoracotomy [4 cases]. The postoperative complications were observed in 4 patients. Low cardiac output was the most common complication [2 patients]. In 13 cases, excluding 2 operative deaths, preoperatively all were in New York Heart Association Class III or IV. At the time of discharge II [85%] were in Class I or II. 4 Cases were reoperated after original pericardiostomy and all resulted in marked improvement. Early surgical intervention is advisable in all patients in whom cardiac constriction is caused by either a thickened pericardium or a pericardial effusion before myocardial dysfunction occurs.

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Empyema and Pericarditis by Salmonella Group D Complicating Malignant Thymoma with Pleural Metastasis (흉선종의 흉막전이에 동반된 Group D Salmonella 농흉 및 심낭염 -1예 보고-)

  • 조덕곤;조민섭;송소향;김치홍;이선희;조규도
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.382-385
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    • 2004
  • Non-typhoid salmonella infection frequently associated with bacteremia rarely been reported in immunocom-promized patients with malignant neoplasms, diabetes or extended use of corticosteroids. Especially, concomitant pleural empyema and pericarditis due to non-typhoid salmonella. infection is extremely rare. Here, we report a case of concomitant empyema and pericarditis in malignant thymoma with pleural. metastasis complicated by salmonella group D infection with brief review of literature.

A case of constrictive pericarditis presenting with protein-losing enteropathy (단백 소실성 장병증을 동반한 교착성 심낭염 1례)

  • Hong, Jeong Mi;Lee, Jae Young;Kim, Soo Jin;Jang, Gi Young;Shim, Woo Sup
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.898-901
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    • 2006
  • Constrictive pericarditis represents a rare cause of protein-losing enteropathy in children. Reported is an 11-year-old girl with protein-losing enteropathy (PLE) as the principal manifestations of constrictive pericarditis. After total pericardiectomy, symptoms and signs of PLE disappeared. Doppler echocardiography including tissue Doppler imaging is a useful noninvasive initial diagnostic tool for differential diagnosis of diastolic heart failure.

Pericardiectomy in Constrictive Pericarditis -23 Cases- (만성 교약성 심낭염의 외과적 치료)

  • 하현철
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.143-149
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    • 1995
  • From January, 1983, to August, 1993, 23 cases of pericardiectomy for chronic constrictive pericarditis were carried out. The 15 male and 8 female patients ranged in age from 7 to 68 years[mean 39.1 years . All patients underwent pericardiectomy through a median sternotomy. Postoperative complications were low cardiac output[2 patients , wound infection[2 patients , pneumonia[2 patients , and unilateral phrenic nerve palsy[2 patients . One patient died of low cardiac output 1 day after pericardiectomy due to the associated transposition of great artery and hypoplastic right lung. Clinical and pathological findings showed that the cause of constrictive pericarditis was tuberculous in 8 cases[34.8% , idiopathic in 12 cases[52.2% and pyogenic in 3 cases[13.0% . Central venous pressure fell below 10cmH2O by immediate in 6 cases, fell below 10cmH2O by 24hrs in 5 cases and continued above 10cmH2O after 24hrs in 12 cases. Preoperative NYHA functional class of patients showed class I-1, classII-4, class III-14, and class IV-3. Postoperativly NYHA functional class was improved to class I-15, classII-6, class III-1.

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Pericardiectomy by a Left Limited Anterolateral Thoracotomy for Constrictive Pericarditis after Cardiac Surgery -2 case reports- (개심술 후 발생한 압축성 심막염에 대한 좌전측방 소개흉술에 의한 심막절제술 - 2예 치험 -)

  • Kim, Tae-Yun;Choi, Jong-Bum;Lee, Mi-Kyung;Kim, Kyung-Hwa;Kim, Min-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.184-187
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    • 2010
  • Although it is a rare complication of cardiac surgery, constrictive pericarditis still remains a difficult problem that needs an appropriate treatment after cardiac surgery. We had two patients with constrictive pericarditis presenting with unexplained right heart failure early after cardiac surgery, and the diagnosis of constrictive pericarditis was made by a specific finding of septal bounce shown in echocardiographic study. On the postoperative 40th day and 31st day, they underwent pericardiectomy by a left limited anterolateral thoracotomy. For one to two weeks since pericardiectomy, the cardiac failure symptoms were gradually relieved. For patients without improvement of the constrictive symptom and sign even with conservative medical therapy for constrictive pericarditis developed early after cardiac surgery, pericardiectomy by a left limited anterolateral thoracotomy is considered as a useful therapeutic mode.

Clozapine-related Sudden Pericarditis in a Patient Taking Long Acting Aripiprazole and Valproate: A Case Report

  • De Berardis, Domenico;Fornaro, Michele;Orsolini, Laura;Olivieri, Luigi;Nappi, Francesco;Rapini, Gabriella;Vellante, Federica;Napoletano, Cosimo;Serroni, Nicola;Di Giannantonio, Massimo
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.505-507
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    • 2018
  • Clozapine may be associated with cardiovascular adverse effects including QTc prolongation and, more rarely, with myocarditis and pericarditis. Although rare, these latter cardiovascular adverse effects may be life-threatening and must be immediately recognized and treated. Several cases of clozapine related-pericarditis have been described and often it has a subtle and insidious onset with symptoms that may be often misdiagnosed with psychiatric manifestations (e.g. anxiety, panic or somatization) leading to a delayed correct diagnosis with potential fatal consequences. In the present report we describe the case of a 27-year-old girl with schizoaffective disorder taking long acting aripiprazole and valproate who developed a sudden onset clozapine-related pericarditis during titration phase that resolved with immediate clozapine discontinuation and indomethacin administration. We underline the importance of an early diagnosis of clozapine-related pericarditis and the need to have monitoring protocols to prevent this potentially fatal adverse effect especially when polypharmacy is administered to patients taking clozapine.

Clinical Experience of Acute Pericarditis with Effusion (삼출액을 동반한 급성심낭염의 임상적 고찰)

  • Park, K.;Yoo, J.S.;Kim, Y.H.;Jo, K.D.;Park, J.K.;Wang, Y.P.;Kim, S.W.;Lee, H.K
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.190-196
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    • 1991
  • Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

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