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Analysis of pericardial fluid.
Source publication
A síndrome pós-lesão cardíaca (SPLC) corresponde a um processo inflamatório envolvendo o pericárdio, secundário à lesão cardíaca. Pode desenvolver-se após traumatismo cardíaco, cirurgia cardíaca, enfarte agudo do miocárdio, e, raramente, após alguns procedimentos intravasculares. Os autores apresentam o caso invulgar de uma rotura cardíaca iatrogén...
Context in source publication
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Citations
... It is thought to be an autoimmune response to a damage of pericardial cells due to myocardial infarction, cardiac surgery, thorax trauma, or cardiac interventions. 1 Cases of PCIS were described after coronary interventions, implantation of cardiac devices and transcatheter aortic valve implantation. [6][7][8][9] However, the diagnosis of PCIS may be challenging. Diagnostic criteria include fever without alternative causes, pleuritic chest pain, friction rub, development of a new or worsening of pericardial effusion in addition to the development of a new or worsening of pleural effusion. ...
Background
Post-cardiac injury syndrome (PCIS) is an inflammatory process that may occur after myocardial infarction, cardiac surgery, percutaneous cardiac interventions or chest trauma. To our knowledge, PCIS following transcatheter mitral valve repair (TMVr) using the MitraClip system has not been reported.
Case summary
A 79-year-old female with chronic heart failure and severe mitral regurgitation received TMVr using the MitraClip system. After the procedure she developed elevated inflammatory markers, pericardial and pleural effusion. Cardiac magnetic resonance provided signs of pericardial and pleural inflammation. After initiating an anti-inflammatory therapy with Aspirin and Colchicine, inflammatory markers decreased markedly, pleural and pericardial effusions were regressive, and the patient showed rapid clinical improvement.
Discussion
Post-cardiac injury syndrome may occur after TMVr and should be considered as a differential diagnosis in patients developing chest pain, signs of pericarditis with or without pericardial effusion and elevated inflammatory markers.
... A PubMed search using the key words 'post-cardiac injury syndrome', 'post-pericardiotomy syndrome', 'post-myocardial infarction syndrome' and 'post-traumatic pericarditis' identified 13 cases written in English with our required clinical data. [4][5][6][7][8][9][10][11][12][13][14] The interval between surgery and the onset of symptoms (or hospital admission) ranged from 16 hours to 3 months in these case reports. In our case, this interval was about 9 months. ...
Postcardiac injury syndrome (PCIS) is a rare condition that is considered to have a trauma-induced autoimmune mechanism triggered by damage to pericardial and/or pleural tissues. We report a case of PCIS accompanied by systemic oedema after thymectomy. A 73-year-old woman was referred to our hospital for dyspnoea and oedema, 9 months after thymectomy. Evaluation revealed the presence of pericardial effusion, pleural effusion and systemic oedema. Differential diagnosis included constrictive pericarditis (secondary to tuberculosis), serositis caused by collagen disease and malignancy. Detailed investigations led to the diagnosis of PCIS, which was successfully treated with prednisolone. This report focuses on the diagnostic approach to PCIS. Since it took time to make a final diagnosis in our patient, we analysed several past case reports and series to determine the cause of the delay in diagnosis.
