A clinical case of a 21-year-old patient with idiopathic acute exudative pericarditis
DOI:
https://doi.org/10.12775/JEHS.2023.15.01.009Keywords
idiopathic acute exudative pericarditisAbstract
act
Pericarditis is a disease entity associated with the primary or secondary inflammation of its layers, which may be accompanied by the accumulation of fluid in the pericardial sac, the consequences of which depend mainly on the speed of its accumulation. The causes of pericardial diseases can be divided into infectious or non-infectious diseases, but in about 30% of cases the etiology of the disease cannot be determined. Pericarditis causes 5% of all emergency department visits related to non-ischemic chest pain.
In the study we presented a case of a 21-year-old Caucasian male with acute exudative pericarditis, which required drainage of the pericardial sac despite the use of pharmacological treatment. The patient underwent a wide range of diagnostic tests and specialist consultations, but ultimately the etiological factor of acute exudative pericarditis could not have been identified.
The therapy of acute exudative pericarditis, especially in the case of undetermined etiology, requires an individualized approach from the attending physician. Based on the observation of inflammatory parameters, imaging tests and clinical picture, the physician is to decide whether pericardiocentesis or modification of pharmacological treatment is necessary. Searching for the etiological factor is essential if it has an impact on the successive methods of diagnosis and treatment, especially in patients with recurrent idiopathic pericarditis or in the absence of a response to the therapy.
References
Kabbani SS, LeWinter MM. Pericardial Diseases. Curr Treat Options Cardiovasc Med 2002;4:487–95.
Imazio M, Gaita F. Diagnosis and treatment of pericarditis. Heart 2015;101:1159–68. doi:10.1136/heartjnl-2014-306362.
Doctor NS, Shah AB, Coplan N, Kronzon I. Acute Pericarditis. Prog Cardiovasc Dis 2017;59:349–59. doi:10.1016/j.pcad.2016.12.001.
Imazio M, Brucato A, DeRosa FG, Lestuzzi C, Bombana E, Scipione F, et al. Aetiological diagnosis in acute and recurrent pericarditis: when and how. J Cardiovasc Med 2009;10:217–30. doi:10.2459/JCM.0b013e328322f9b1.
Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y. Controversial issues in the management of pericardial diseases. Circulation 2010;121:916–28. doi:10.1161/CIRCULATIONAHA.108.844753.
Permanyer-Miralda G. Acute pericardial disease: approach to the aetiologic diagnosis. Heart 2004;90:252–4. doi:10.1136/hrt.2003.024802.
Imazio M, Bobbio M, Cecchi E, Demarie D, Demichelis B, Pomari F, et al. Colchicine in Addition to Conventional Therapy for Acute Pericarditis: Results of the COlchicine for acute PEricarditis (COPE) Trial. Circulation 2005;112:2012–6. doi:10.1161/CIRCULATIONAHA.105.542738.
Imazio M, Brucato A, Cemin R, Ferrua S, Maggiolini S, Beqaraj F, et al. A Randomized Trial of Colchicine for Acute Pericarditis. N Engl J Med 2013;369:1522–8. doi:10.1056/NEJMoa1208536.
Solomon CG, LeWinter MM. Acute Pericarditis. N Engl J Med 2014;371:2410–6. doi:10.1056/NEJMcp1404070.
Elfströ M P, Hamsten A, Montgomery SM, Ekbom A, Ludvigsson JF. Cardiomyopathy, pericarditis and myocarditis in a population-based cohort of inpatients with coeliac disease n.d. doi:10.1111/j.1365-2796.2007.01843.x.
Kytö V, Sipilä J, Rautava P. Clinical profile and influences on outcomes in patients hospitalized for acute pericarditis. Circulation 2014;130:1601–6. doi:10.1161/CIRCULATIONAHA.114.010376.
Wołowiec Ł, Rogowicz D, Banach J, Gilewski W, Sinkiewicz W, Grześk G. Catestatin as a New Prognostic Marker in Stable Patients with Heart Failure with Reduced Ejection Fraction in Two-Year Follow-Up. Dis Markers. 2020;8847211. doi:10.1155/2020/8847211.
Wołowiec Ł, Banach J, Budzyński J, Wołowiec A, Kozakiewicz M, Bieliński M, Jaśniak A, Olejarczyk A, Grześk G. Prognostic Value of Plasma Catestatin Concentration in Patients with Heart Failure with Reduced Ejection Fraction in Two-Year Follow-Up. Journal of Clinical Medicine. 2023;12(13):4208. doi:10.3390/jcm12134208.
Banach J, Wołowiec Ł, Rogowicz D, et al., Procalcitonin (PCT) predicts worse outcome in patients with chronic heart failure with reduced ejection fraction (HFrEF), Disease Markers, 2018; 6. doi:10.1155/2018/9542784
Ł. Wołowiec Ł, Rogowicz D, Banach J, et al., “Prognostic significance of red cell distribution width and other red cell parameters in patients with chronic heart failure during two years of follow-up,” Kardiologia Polska, 2016;74(7):657–664. doi:10.5603/KP.a2016.0004
Banach J, Grochowska M, Gackowska L, Buszko K, Bujak R, Gilewski W, Kubiszewska L, Wołowiec Ł, Michałkiewicz J, Sinkiewicz W. Melanoma cell adhesion molecule as an emerging biomarker with prognostic significance in systolic heart failure. Biomark. Med. 2016;10:733–742. doi:10.2217/bmm-2016-0053
Rogowicz D, Wołowiec Ł, Banach J, Buszko K, Mosiądz P, Gilewski W, Zukow W, Sinkiewicz W. Usefulness of serum high-sensitivity C-reactive protein (hs-CRP) level as prognostic factor in patients with chronic heart failure. J. Educ. Health Sport 2016;6:513–524.
Imazio M, Gaita F, LeWinter M. Evaluation and Treatment of Pericarditis. JAMA 2015;314:1498. doi:10.1001/jama.2015.12763.
Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet (London, England) 2004;363:717–27. doi:10.1016/S0140-6736(04)15648-1.
Katinaitė J. Recurrent pericarditis : a case report and literature review 2017;24:159–66.
Hammer Y, Bishara J, Eisen A, Iakobishvili Z, Kornowski R, Mager A. Seasonal patterns of acute and recurrent idiopathic pericarditis. Clin Cardiol 2017;40:1152–5. doi:10.1002/clc.22804.
Levy PY, Corey R, Berger P, Habib G, Bonnet JL, Levy S, et al. Etiologic Diagnosis of 204 Pericardial Effusions. Medicine (Baltimore) 2003;82:385–91. doi:10.1097/01.md.0000101574.54295.73.
Sagristà-Sauleda J, Mercé J, Permanyer-Miralda G, Soler-Soler J. Clinical clues to the causes of large pericardial effusions. Am J Med 2000;109:95–101.
Corey GR, Campbell PT, Van Trigt P, Kenney RT, O’Connor CM, Sheikh KH, et al. Etiology of large pericardial effusions. Am J Med 1993;95:209–13.
Reuter H, Burgess LJ, Doubell AF. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect 2005;133:393–9.
Ma W, Liu J, Zeng Y, Chen S, Zheng Y, Ye S, et al. Causes of moderate to large pericardial effusion requiring pericardiocentesis in 140 Han Chinese patients. Herz 2012;37:183–7. doi:10.1007/s00059-011-3428-5.
Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, et al. Wytyczne ESC dotyczce rozpoznawania i leczenia chorób osierdzia w 2015 roku. Kardiol Pol 2015;73:1028–91. doi:10.5603/KP.2015.0228.
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Copyright (c) 2023 Łukasz Wołowiec, Daniel Rogowicz, Robert Bujak, Anna Choma, Albert Jaśniak, Joanna Osiak, Anna Wołowiec, Grzegorz Grześk, Walery Zukow
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