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Cardiology
Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with duchenne muscular dystrophy
Ho Jung Choi, Hye Won Kwon, Kyung Jin Oh, Mi Kyoung Song
Acute Crit Care. 2022;37(2):258-262.   Published online November 16, 2021
DOI: https://doi.org/10.4266/acc.2021.00290
  • 5,431 View
  • 253 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Differential diagnosis of chest pain in the pediatric population is important but can be challenging. A 12-year-old boy with Duchenne muscular dystrophy presented with chest pain, cardiac enzyme elevation, and convex ST elevations in the inferior leads with reciprocal ST depression in the anterior leads on electrocardiogram. Echocardiography on admission revealed normal left ventricular function. Suspecting acute myocardial infarction, we performed invasive coronary angiography, which revealed normal coronary arteries. A follow-up electrocardiogram showed an acute pericarditis pattern with concave ST elevations in most leads and PR depression, and follow-up echocardiography revealed global left ventricular dysfunction, suggestive of acute perimyocarditis. Ibuprofen was administered for acute pericarditis, and a continuous milrinone infusion was commenced for myocardial dysfunction. The chest pain improved by the next day, and the ST segment elevations normalized on day 4. Echocardiography on day 9 revealed improved left ventricular function. The patient was discharged on day 11, and he is doing well without chest pain through 12 months of follow-up. The last electrocardiogram showed normal sinus rhythm without ST change. Differential diagnosis of acute myocardial infarction and acute perimyocarditis is important for proper treatment strategies and the different prognoses of these two conditions.

Citations

Citations to this article as recorded by  
  • Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department
    Szu-Wei Huang, Ying-Kuo Liu
    Diagnostics.2024; 14(5): 526.     CrossRef
  • Successful treatment of acute myocardial injury of Duchenne muscular dystrophy with steroids: a case report
    Merve Oğuz, Dolunay Gürses, Furkan Ufuk, Münevver Yılmaz, Olcay Güngör
    Journal of Cardiothoracic Surgery.2023;[Epub]     CrossRef
  • Comprehensive cardiac magnetic resonance T1, T2, and extracellular volume mapping to define Duchenne cardiomyopathy
    Sudeep D. Sunthankar, Kristen George-Durrett, Kimberly Crum, James C. Slaughter, Jennifer Kasten, Frank J. Raucci, Larry W. Markham, Jonathan H. Soslow
    Journal of Cardiovascular Magnetic Resonance.2023; 25(1): 44.     CrossRef
Cardiology
A successfully treated case of primary purulent pericarditis complicated by cardiac tamponade and pneumopericardium
Jong Wook Beom, Yeekyoung Ko, Ki Yung Boo, Jae-Geun Lee, Joon Hyouk Choi, Seung-Jae Joo, Ji Hwan Moon, Su Wan Kim, Song-Yi Kim
Acute Crit Care. 2021;36(1):70-74.   Published online October 12, 2020
DOI: https://doi.org/10.4266/acc.2020.00234
  • 9,981 View
  • 179 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Acute pericarditis is caused by various factors, but purulent pericarditis is rare. Primary purulent pericarditis in immunocompetent hosts is very rare in the modern antibiotics era. We report a successfully treated case of primary purulent pericarditis complicated with cardiac tamponade and pneumopericardium in an immunocompetent host. A 69-year-old female was referred from another hospital because of pleuritic chest pain with a large amount of pericardial effusion. She was diagnosed with acute pericarditis accompanied by cardiac tamponade. We performed emergency pericardiocentesis, with drainage of 360 ml of bloody pericardial fluid. The culture grew Streptococcus anginosus, confirming the diagnosis of acute purulent pericarditis. We performed pericardiostomy because cardiomegaly and pneumopericardium were aggravated after removal of the pericardial drainage catheter. The patient received antibiotics for a total of 23 days intravenously and was discharged with oral antibiotic therapy. Purulent pericarditis is one of the rare forms of pericarditis and is lifethreatening. A multimodality approach is required for proper diagnosis and treatment of this disease.

Citations

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  • A Rare Case of Primary Purulent Pericarditis Caused by Streptococcus constellatus
    Medeinė Kapačinskaitė, Dovilė Gabartaitė, Agnė Šatrauskienė, Ieva Sakaitė, Vytė Valerija Maneikienė, Aleksejus Zorinas, Vilius Janušauskas
    Medicina.2023; 59(1): 159.     CrossRef
  • The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding
    Magdalena Pilarczyk-Zurek, Izabela Sitkiewicz, Joanna Koziel
    Frontiers in Microbiology.2022;[Epub]     CrossRef
  • The effects of pneumopericardium during epicardial catheter ablation after dry pericardiocentesis on patients with ventricular arrhythmia
    Qingyong Chen, Bosen Yang, Zhenggang Lai, Wen Yue, Qing Yang
    Journal of Interventional Cardiac Electrophysiology.2022; 66(2): 373.     CrossRef
A Case of Purulent Pericarditis Complicated by Klebsiella pneumoniae Sepsis - A Case Report -
Byeong Ho Jeong, Seungmin Chung, Hee Jin Kwon, Kyeongman Jeon
Korean J Crit Care Med. 2013;28(1):51-55.
DOI: https://doi.org/10.4266/kjccm.2013.28.1.51
  • 2,757 View
  • 36 Download
AbstractAbstract PDF
Although the incidence of purulent pericarditis has decreased significantly in the modern antibiotic era, purulent pericarditis remains a life-threatening disease. Therefore, a high index of clinical suspicion should be maintained to diagnose this life-threatening illness at an early stage. We report an extraordinary case of purulent pericarditis, caused by Klebsiella pneumoniae bacteremia, which developed during the recovery of septic shock with urinary tract infection. Despite of early diagnosis and pericardial drainage, in addition to adequate antibiotics, the patient subsequently developed multiple organ failure leading to death. The case highlights that purulent pericarditis is a rare yet possible disorder complicated from septic shock with bacteremia in the antibiotic era. Therefore, purulent pericarditis should always be considered as a possible complication, especially in patients with K. pneumoniae bacteremia and progressive cardiomegaly.
A Case of Uremic Pericarditis and Cardiac Tamponade That Developed after Ethylene Glycol Poisoning: A Case Report
Ki Ju Kim, Jung Gil Park, Han Jun Ryu, Yeoun Su Jung, Sung Ho Kim, Bong Ryeol Lee, Byung Chun Jung, Hyun Jae Kang
Korean J Crit Care Med. 2010;25(3):176-181.
DOI: https://doi.org/10.4266/kjccm.2010.25.3.176
  • 2,934 View
  • 108 Download
  • 1 Crossref
AbstractAbstract PDF
Ethylene glycol is commonly incorporated into automotive antifreeze agents and a variety of other commercial products. Ethylene glycol poisoning can cause life-threatening metabolic acidosis, cardiopulmonary failure, and renal failure that may be fatal. We present an unusual case of a patient who ingested a large amount of ethylene glycol for the purpose of suicide and developed multiorgan damage, including acute renal failure followed by uremic pericarditis and cardiac tamponade. This unusual complication was effectively managed with echocardiography-guided percutaneous pericardiocentesis and continuous catheter drainage for 3 days. After intensive hemodialysis and supportive care, the patient made a good recovery with near normal cardiac and renal function. Physicians should be aware of the possibility of acute pericarditis and cardiac tamponade in cases of acute renal failure caused by ethylene glycol poisoning.

Citations

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  • Deneysel Etilen Glikol Zehirlenmesi Oluşturulan Ratlarda Myokardiyal Etkilerin Araştırılması*,**
    Burak DOĞAN, Vehbi GÜNEŞ
    Erciyes Üniversitesi Veteriner Fakültesi Dergisi.2020; 17(3): 275.     CrossRef

ACC : Acute and Critical Care