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PubMed1980

[Difficulties and errors in diagnosing exudative pericarditis].

The peculiar features of the course of atypical variants of pericarditis with effusion are considered on the basis of concrete clinical cases, and the informative value of some symptoms and their reliability in making the diagnosis are discussed. Examples are given of patients with adhesive pericarditis with effusion some of whom developed heart tamponade with fluid in the formation of a non-stretchable external capsule and others had compression by the internal capsule.

Aged↗
PubMed2004

Interferon-gamma protects against chronic viral myocarditis by reducing mast cell degranulation, fibrosis, and the profibrotic cytokines transforming growth factor-beta 1, interleukin-1 beta, and interleukin-4 in the heart.

Inflammatory fibrosis is a characteristic feature of myocarditis, dilated cardiomyopathy (DCM), and congestive heart failure. Th1-type immune responses, mediated by interleukin (IL)-12-induced interferon (IFN)-gamma, are believed to exacerbate autoimmune diseases including myocarditis. In this study, we examined the effect of IL-12R beta 1 and IFN-gamma deficiency on the development of chronic CB3-induced myocarditis using knockout mice. We found increased chronic CB3-induced myocarditis (14.1 to 43.1%, P < 0.001); pericarditis (1.5 to 7.6%, P < 0.001); fibrosis (9.7 to 27.4%, P < 0.05); and the profibrotic cytokines transforming growth factor-beta(1), IL-1 beta, and IL-4 in the hearts of IFN-gamma-deficient mice. All mice infected with CB3 developed DCM, but IFN-gamma-deficient mice developed a fibrous, adhesive pericarditis associated with increased numbers of degranulating mast cells (MCs) in the pericardium (26.6 to 45.9%, P < 0.01), increased histamine levels (716 to 1930 ng/g of heart, P < 0.01), and reduced survival (100 to 43%). In contrast, IL-12R beta 1 deficiency did not significantly alter the development of chronic myocarditis. Thus, IFN-gamma protects against the development of severe chronic myocarditis, pericarditis, and DCM after CB3 infection by reducing MC degranulation, fibrosis, and the profibrotic cytokines transforming growth factor-beta(1), IL-1 beta, and IL-4 in the heart.

Animals↗
PubMed2004

[Extracardiac causes of right ventricular insufficiency].

Evidence for manifest right ventricular dysfunction is considered a critical threshold in the development of a fatal event after acute pulmonary embolism. While the acute event impressively reflects the clinical significance of right ventricular function, various disorders such as idiopathic pulmonary arterial hypertension, secondary pulmonary hypertension in lung diseases, carcinoid heart disease, and portopulmonary hypertension can lead to chronic right ventricular failure. Adapted treatment makes it possible to alleviate the patients' distress and presumably also improve the prognosis. The clinical picture of right ventricular insufficiency can also be imitated in constrictive or adhesive pericarditis and pericardial tamponade. Pericardiocentesis of the tamponade provides initial hemodynamic improvement. Causal treatment is based on cytological findings and/or results of epicardial or pericardial biopsy to classify malignant and nonmalignant effusions. Cardiac surgery with pericardiolysis and (partial) pericardial resection remains the method of choice for symptomatic constrictive pericarditis.

Acute Disease↗
PubMed1975

Cardiac involvement in Whipple's disease.

Although cardiac involvement in Whipple's disease has been reported previously, the extent and significance of such involvement has not been stressed. In our series of 19 patients, 58% had clinical cardiac findings and 79% had gross cardiac lesions at autopsy. Histologically there were PAS-positive macrophages in the pericardium, myocardium, and valves of each of these patients. These collections of macrophages were associated with chronic inflammatory cells and foci of fibrosis with resultant adhesive pericarditis, focal myocardial fibrosis similar to the fibrosis of idiopathic cardiomyopathy, and valvular fibrosis with deformity grossly resembling the valvular lesions of chronic rheumatic heart disease. Four of the patients with mitral valvular deformity had cardiac murmurs, and ECG changes were noted in six patients with mitral myocardial fibrosis. In addition, pericardial friction rubs were heard in two patients. By electron microscopy rod-shaped bodies, presumably bacteria, were noted in the mitral valve and myocardium. The structures are identical to those described in the small intestinal mucosa of patients with Whipple's disease and presumably are the causative agent of the pancardiopathy.

Adult↗
PubMed2002

[Surgical correction of the rheumatic concomitant mitral-aortal failure complicated by thrombosis of the left auricle].

The results of surgical treatment of 51 patients with the thrombosis of the left auricle (LA), occurred after performance of intervention for the rheumatic concomitant mitral-aortal failure (RCMAF) of the heart were analyzed. The substitution of two valves was performed in 37 patients, valve-preserving operations in combination with the prosthesis--in 14. The massive thrombosis of LA (more than 1/3 volume) occurred in 16 (31%) patients. On the hospital stage 17 patients, mainly with complicated current and organic failure of the tricuspid valve in combination with the adhesive pericarditis, calcinosis of the valves, and also previously operated for the heart, died. The late results (from 1 to 12 yrs) of intervention were studied in 33 patients. Good result was noted in 20 (60.6%) patients, satisfactory--in 5 (15.2%), nonsatisfactory--in 1 (9.1%). 5 (15.2%) patients died mainly because of the thromboembolic complications. The thromboembolic complications were not noted in patients to whom the valve-preserving procedures were conducted. All the patients in this group are alive.

Adult↗
PubMed2004

[The heart damage in patients with psoriatic arthritis].

AIM: To examine the rate and features of heart damage in psoriatic arthritis (PA) patients and find out whether some parameters of PA are associated with cardiac involvement. MATERIAL AND METHODS: The study enrolled 370 PA patients aged 15 to 72 years with the disease history 1 to 44 years having different variants of the articular and skin syndromes. The patients have undergone various tests including chest x-ray, ECG, echocardiography. RESULTS: Myocarditis, adhesive pericarditis, valvular defects (mitral, aortic and combined mitral-aortic were diagnosed in 15.9, 18.2 and 5.7% of PA patients, respectively). Aortitis was detected in 51.3% patients with advanced sacroileitis and alkylosing spondylarthritis. Alterations in the heart were associated with spinal lesions, other systemic manifestations, activity of the disease and, in a lesser degree, with carriage of HLA-B27. CONCLUSION: Cardiac syndrome in PA is characterized by marked heterogeneity and is one of basic systemic manifestations of this disease. Latent PA aortatis can be detected at echocardiography.

Adolescent↗
PubMedDate not supplied

[Headache induced by oral intake of metoprolol in a patient with chronic and limited cardiac tamponade].

The papers describing the secondary headache attributed simultaneously to vascular disorder beyond the head and neck and use of drug are lacking. There is no adequate position for that type of headache in the current classification of headache, either. The case of secondary headache induced by metoprolol in a 57-year-old patient with superior vena cava syndrome (SVCS) is reported. He suffered from chronic paroxysmal headache with accompanying rash and the superficial jugular veins were over-flown about 30 minutes after an intake of 25 mg of metoprolol. At the seventh day of hospital stay, the sudden death occurred. Postmortem examination showed the limited cardiac tamponade caused by aortal perforation and adhesive pericarditis SVCS produced by chronic, limited cardiac tamponade revealed after oral intake of metoprolol can be the cause of secondary headache that might be defined as "headache attributed to vascular disorder beyond the head and neck and related to medication for other indications".

Adrenergic beta-Antagonists↗
PubMed1989

[Extensive partial agenesis of the left pericardium. An anatomo-clinical correlation. Report of 2 cases].

The authors report on two patients with large partial congenital defect of the left pericardium, as observed at post-mortem examination. In both cases, diagnosis was made during life thanks to the clinical syndrome described by Abbott, Sothworth and Stenvenson. In the first case diagnosis was confirmed by pneumothorax proposed by Ellis et al and the second case was recognized by the clinical-radiological syndrome. The first patient was followed until his death. Because of an abnormal echogram, he was submitted to exploratory cardiotomy and small ASD, aneurysmatic dilation of Valsalva sinus and mitral regurgitation by ruptured chordae tendineae were found. The autopsy, besides the findings at the operation, showed residual adhesive pericarditis with a cavity at the postero-superior region of the heart behind the left auricle and a redundant tricuspid cusp. The association of congenital pericardium defect to mitro-tricuspid redundant cusps and aneurysmatic dilatation of the sinus of Valsalva--suggesting myxomatous degeneration--plus atrial septal defect as in case 1, has not been found in the medical literature. In the second patient the defect was recognized in spite of congestive heart failure and severe tricuspid regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[2-dimensional echocardiography in the evaluation of pericardial pathology: new prospects for its differential diagnosis].

We examined retrospectively the M-mode and two-dimensional echocardiograms performed in our laboratory on 227 patients with pericardial diseases, in order to assess the capabilities and limits of echocardiography in this field. We observed 4 patients with congenital absence of the pericardium, 10 with of constrictive or infiltrative-adhesive pericarditis, 213 pericardial effusions, associated with left pleural effusion in 36 cases and with different kinds of intrapericardial masses in 33 cases. Through qualitative analysis of the echogenicity of such masses some aspects were singled out which may prove useful in identifying intrapericardial fat, as well as tumors. We also suggest new ways of using specific echocardiographic sections to differentiate left pleural effusions from pericardial effusions, and to identify very small pericardial effusions.

Adolescent↗