Como eu faço avaliação ecocardiográfica de pericardite constritiva / My approach to echocardiographic assessment for constrictive pericarditis

A pericardite constritiva (PC) é uma condição na qual a cicatrização e perda de elasticidade do pericárdio resultam em enchimento ventricular prejudicado, disfunção diastólica e insuficiência cardíaca direita. O diagnóstico dessa patologia é desafiador, sendo frequente a necessidade de técnicas de imagem multimodal, dentre as quais a ecocardiografia representa a modalidade de imagem inicial para a avaliação diagnóstica, além de permitir a diferenciação da PC da cardiomiopatia restritiva (CMR) e outras condições que mimetizam constrição. (AU)

Constrictive pericarditis (CP) is a condition in which scarring and loss of elasticity of the pericardium result in impaired ventricular filling, diastolic dysfunction, and right heart failure. The diagnosis of this pathology is challenging, with frequent need for multimodal imaging techniques, among which echocardiography represents the initial imaging modality for the diagnostic evaluation, in addition to allowing the differentiation of CP from restrictive cardiomyopathy (RCM) and other conditions that mimic constriction. (AU)

COVID-19 related myopericarditis in a 29-year-old patient: A case report

Introduction: The manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, are mainly characterized by respiratory symptoms. However, cardiac manifestations such as acute myopericarditis have been reported to be associated with COVID-19 infection. Case Description: A 29-year-old female patient presented with a 2-day history of fever, cough, runny nose, and myalgia, and tested COVID-19 positive at Penang General Hospital, Pulau Pinang, Malaysia. On day 2 of admission, the patient complained of acute onset central chest pain, radiating to her back, associated with cold sweat, shortness of breath and generalised body ache. On examination, tachycardia and tachypnoea were elicited. The serial electrocardiography (ECG) showed persistent non-specific sinus tachycardia. Troponin T level was elevated at 99 ng/L (normal <15 ng/L) and creatine kinase (CK) was at 10990 U//L (normal: <190 U/L). Her chest radiograph revealed cardiomegaly and otherwise clear lung field. CT pulmonary angiogram demonstrated evidence of bilateral pleural effusion and pericardial effusion and ruled out pulmonary embolism. The diagnosis of myopericarditis was established based on clinical, electrocardiographic, radiological, and biochemical findings. She was treated successfully with IV morphine, oral colchicine, ibuprofen, and oxygen therapy. A follow-up echocardiogram 10 weeks postCOVID demonstrated complete resolution of pericardial effusion, with an election fraction of >70%. Conclusion: COVID-19 patients may develop severe cardiac complications such as myopericarditis. Clinicians should have a high index of suspicion of COVID-related myopericarditis in COVID-19 management. Further study should be implemented to investigate the association between COVID-19 and myopericarditis.

A rare case of tuberculous polyserositis � A case report

Polyserositis is defined as chronic inflammation of several serous membranes with effusions in serous cavities like Pericardial, Pleural and Peritoneal membranes, resulting in fibrous thickening of the serous membranes and sometimes constrictive pericarditis. There are various causes of polyserositis which include autoimmune diseases, neoplasia, endocrine diseases, drug � related causes and infectious diseases such as tuberculosis. Polyserositis in disseminated TB is a very rare presentation. Diagnosis is often delayed due to the non-specific presentation like polyserositis and its unusual nature. We herewith report a rare case of TB polyserositis, involving pleura, pericardium and peritoneum.

Surgical Treatment of Constrictive Pericarditis

ABSTRACT Introduction: The mainstay of the treatment of constrictive pericarditis is pericardiectomy. However, surgery is associated with high early morbidity and mortality and low long-term survival. The aim of this study is to describe our series of pericardiectomies performed over 30 years. Methods: A descriptive, observational, and retrospective analysis of all pericardiectomies performed at the Institute of Cardiology and Cardiovascular Surgery of the Favaloro Foundation was performed. Results: A total of 45 patients underwent pericardiectomy between June 1992 and June 2022, mean age was 52 years (standard deviation ± 13.9 years), and 73.3% were men. Idiopathic constrictive pericarditis was the most prevalent (46.6%). The variables significantly associated with prolonged hospitalization were preoperative advanced functional class (incidence of 38.4%, P<0.04), persistent pleural effusion (incidence of 81.8%, P<0.01), and although there was no statistical significance with the use of cardiopulmonary bypass, a trend in this association is evident (P<0.07). We found that 100% of the patients with an onset of symptoms greater than six months had a prolonged hospital stay. In-hospital mortality was 6.6%, and 30-day mortality was 8.8%. The preserved functional class is 17 times more likely to improve their symptomatology after pericardiectomy (odds ratio 17, 95% confidence interval 2.66-71; P<0.05). Conclusion: Advanced functional class at the time of pericardiectomy is the variable most strongly associated with mortality and prolonged hospitalization. Onset of the symptoms greater than six months is also a poor prognostic factor mainly associated with prolonged hospitalization; based on these data, we strongly support the recommendation of early intervention.

Constrictive Pericarditis and Cardiac Tamponade Due to Tuberculosis as Presentation of Human Immunodeficiency Virus/Syndrome of Acquired Immunodeficiency: Case Report / Pericarditis constrictiva y taponamiento cardíaco por tuberculosis como presentación de virus de inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida: presentación de caso / Pericardite constritiva e tamponamento cardíaco devido à tuberculose com uma apre-sentação do vírus da imunodeficiência adquirida: relato de cas

We report a case of constrictive pericarditis due to extrapulmonary tuberculosis associated with Human Immuno-deficiency Virus, complicated by cardiac tamponade that required surgical intervention in a drug user patient. The importance of early diagnosis and management is widely highlighted

El artículo presenta un caso de pericarditis constrictiva secundaria a tuberculosis extrapulmonar en un paciente con prueba positiva para virus de inmunodeficiencia humana (VIH) consumidor de sustancias psicoactivas, quien durante la hospitalización desarrolló un taponamiento cardíaco con requerimiento de intervención quirúrgica. Se plantea la discusión de la importancia de cada una de las pruebas solicitadas y el manejo adecuado en pacientes con dichas patologías

O artigo apresenta um caso de pericardite constritiva secundária à tuberculose extrapulmonar em paciente com teste positiva para vírus da imunodeficiência humana (HIV) e usuário de substâncias psicoativas que, durante a internação, desenvolveu tamponamento cardíaco com necessidade de intervenção cirúrgica. Discute-se a importância de cada um dos exames solicitados e o manejo ade-quado de pacientes com essas patologias

A rare case of purulent pericarditis secondary to subdiaphragmatic abscess / 世界急诊医学杂志（英文）

@#Subdiaphragmatic abscess is the accumulation of pus in the space between the diaphragm and the transverse colon and its mesentery.[1] Subdiaphragmatic abscess is clinically characterized by fever and local pain. Its clinical manifestations are often vague and diverse, and its symptoms and signs together constitute thoracoabdominal syndrome, leading to delayed diagnosis and a high incidence rate and mortality.[2]Subdiaphragmatic abscess is often secondary to acute peritonitis or remote infection with hematogenous dissemination. The bacteriological characteristics of these abscesses include aerobic and facultative bacteria, such as Escherichia coli, group D Enterococcus and Staphylococcus aureus, as well as less common anaerobic organisms, such as Bacteroides.[3] In 1938, Ochsner and DeBakey recognized chest complications of subdiaphragmatic abscesses, including empyema, bronchial fistula, and pericarditis, in their classic review of subdiaphragmatic abscesses. Because of the structural characteristics of the diaphragm, there are fewer complications of diaphragm perforation.[4] Especially now, with the use of antibiotics, these complications have become more rare. Here, we report a case of purulent pericarditis caused by Klebsiella pneumonia, secondary to subdiaphragmatic abscess extending through the diaphragm.

A review of COVID-19 vaccination and the reported cardiac manifestations

In Singapore, 9.03 million doses of the mRNA COVID-19 vaccines by Pfizer-BioNTech and Moderna have been administered, and 4.46 million people are fully vaccinated. An additional 87,000 people have been vaccinated with vaccines in World Health Organization's Emergency Use Listing. The aim of this review is to explore the reported cardiac adverse events associated with different types of COVID-19 vaccines. A total of 42 studies that reported cardiac side effects after COVID-19 vaccination were included in this study. Reported COVID-19 vaccine-associated cardiac adverse events were mainly myocarditis and pericarditis, most commonly seen in adolescent and young adult male individuals after mRNA vaccination. Reports of other events such as acute myocardial infarction, arrhythmia and stress cardiomyopathy were rare. Outcomes of post-vaccine myocarditis and pericarditis were good. Given the good vaccine efficacy and the high number of cases of infection, hospitalisation and death that could potentially be prevented, COVID-19 vaccine remains of overall benefit, based on the current available data.

A Case Report of Pericardial Mesothelioma Misdiagnosed as Tuberculous Pericarditis / 罕见病研究

A 40-year-old male patient presented with an unexplained pericardial effusion and was treated with antituberculosis therapy. This patient showed a transient improvement, but then progressively worsened to develop constrictive pericarditis, multiple plasma chamber effusions, and venous thrombosis. The patient was transferred to Zhongshan Hospital, Fudan University. Through a pleural histopathological biopsy, this patient was diagnosed with pleural mesothelioma and secondary malignant tumor of the pericardium. Later, clinical the manifestations of patient progressed rapidly, resulting in the death of the patient. Mesothelioma is a very rare group of malignant tumors originating from the pleura and other tissues. Patients are mostly advanced at the time of initial diagnosis, with limited treatments and short median survival. It is important to strengthen the understanding of mesothelioma, pay attention to all medical and technical examinations, especially dynamic follow-up of changes in the disease for early diagnosis of this disease.

Pericarditis purulenta por mycobacterium tuberculosis y streptococcus pneumoniae: revisión del tema, a propósito de un caso / Purulent pericarditis due to mycobacterium tuberculosis and streptococcus pneumoniae: case report and review

La pericarditis purulenta es una patología poco frecuente pero que conlleva alta mortalidad. En la era pre antibióticos, se observaba en pacientes con neumonía complicada y las cocáceas gram positivas eran los gérmenes frecuentemente involucrados. Por otro lado, la pericarditis tuberculosa representa el 1% del total de casos de tuberculosis, aunque es frecuente zonas endémicas, principalmente asociada a la infección por el virus de la inmunodeficiencia humana (VIH). Presentamos el caso de un paciente de 19 años, en situación calle, infectado con VIH, con diagnóstico de pericarditis purulenta, donde se demostró la co-infección de Mycobacterium tuberculosis y Streptecoccus pneumoniae en el pericardio. La pericarditis purulenta polimicrobiana es poco frecuente y la co-infección por los gérmenes mencionados es anecdótica. A pesar del tratamiento antimicrobiano, el aseo quirúrgico, los esteroides y la fibrinolisis intrapericárdica, esta patología tiene un pronóstico ominoso, en parte, debido a la condición basal de los enfermos que la padecen.

Purulent pericarditis is a rare disease with a high mortality rate. In the pre-antibiotic era it was observed as a complication in patients with pneumonia. Gram-positive coccaceae were the most commonly implicated bacteria. Tuberculous pericarditis represents 1% of all tuberculosis (TBC) cases, although it is common in endemic areas, associated with human immunodeficiency virus (HIV) infection. We present the case of a 19-year-old homeless, admitted with HIV and malnutrition, diagnosed with purulent pericarditis. Mycobacterium tuberculosis and Streptococcus pneumoniae were found as a cause of purulent pericarditis. Polymicrobial purulent pericarditis is a rare condition and co-infection with the bacteria previously mentioned is merely anecdotal. Despite antimicrobial treatment, surgical management, steroids, and intrapericardial fibrinolysis, this pathology has an ominous prognosis, due in part to the pre-existing condition of these patients.

Dialysis-related constrictive pericarditis: old enemies may sometimes come back / Pericardite Constritiva relacionada a diálise: velhos inimigos podem, às vezes, voltar

ABSTRACT Cardiovascular disease is the main cause of death in patients with chronic kidney disease (CKD). Several heart conditions have been associated with CKD, including myocardial and pericardial diseases. This paper describes a case of Dialysis-related constrictive pericarditis in a patient diagnosed with sudden hypotension during a hemodialysis session. A 65-year-old man diagnosed with hypertension, diabetes, obesity, and cirrhosis on hemodialysis for two years complained of symptoms during one of his sessions described as malaise, lipothymia, and confusion. The patient had a record of poor compliance with the prescribed diet and missed dialysis sessions. He was sluggish during the physical examination, and presented hypophonetic heart sounds, a blood pressure of 50/30mmHg, and a prolonged capillary refill time. The patient was referred to the intensive care unit and was started on antibiotics and vasoactive drugs. His workup did not show signs of infection, while electrocardiography showed low QRS-wave voltage. His echocardiogram showed signs consistent with a thickened pericardium without pericardial effusion. Cardiac catheterization showed equalization of diastolic pressures in all heart chambers indicative of constrictive pericarditis. The patient underwent a pericardiectomy. Examination of surgical specimens indicated he had marked fibrosis and areas of dystrophic calcification without evidence of infection, consistent with Dialysis-related constrictive pericarditis. Hypotension for unknown causes must be considered in the differential diagnosis of dialysis patients.

RESUMO A doença cardiovascular é a principal causa de morte em pacientes com doença renal crônica (DRC). Várias formas de acometimento cardíaco têm sido associadas. à DRC, incluindo doenças miocárdicas e pericárdicas. Este artigo descreve um caso de pericardite constritiva relacionada a em um paciente diagnosticado com hipotensão súbita durante uma sessão de hemodiálise. Um homem de 65 anos com diagnósticos prévios de hipertensão, diabetes, obesidade e cirrose em hemodiálise por dois anos queixou-se de sintomas durante uma de suas sessões, descritos como mal-estar, lipotímia e confusão mental. Apresentava histórico de baixa adesão à dieta prescrita e faltas frequentes às sessões de diálise. Ele estava fraco durante o exame físico e apresentava bulhas cardíacas hipofonéticas, pressão arterial de 50/30mmHg e tempo de enchimento capilar prolongado. O paciente foi encaminhado para a unidade de terapia intensiva e iniciou o tratamento com antibióticos e drogas vasoativas. Investigação laboratorial não mostrou sinais de infecção, enquanto o eletrocardiograma mostrou baixa voltagem de complexo QRS. Seu ecocardiograma evidenciou sinais consistentes com um pericárdio espessado, sem derrame pericárdico. O cateterismo cardíaco mostrou equalização das pressões diastólicas em todas as câmaras cardíacas, indicativo de pericardite constritiva. O paciente foi submetido a uma pericardiectomia. O exame anatomopatológico mostrou sinais de acentuada fibrose acentuada fibrose e áreas de calcificação distrófica sem evidência de infecção, consistente com pericardite constritiva relacionada a por diálise. A hipotensão por causas desconhecidas deve ser considerada no diagnóstico diferencial de pacientes em diálise.

Miopericarditis inducida por altas dosis de citarabina: cuando el corazón se debilita, pero la lucha contra el cáncer se fortalece / High dose cytarabine induced myopericarditis: When the heart debilitates but the fight against cancer must be strong

Resumen La cardiotoxicidad por citarabina es un efecto adverso poco conocido. Se presenta el caso de un paciente de 51 años con antecedentes de Leucemia Mieloide Aguda manejada con altas dosis de citarabina y que presentó como consecuencia miopericarditis aguda. Luego del manejo de soporte en cuidados intensivos, se inició tratamiento cardioprotector específico para falla cardiaca y, dada la alta posibilidad de requerir citarabina en el manejo oncológico ulterior, se inició tratamiento con antinflamatorios no esteroideos y colchicina con el fin de reducir el riesgo de recurrencia de la miopericarditis. Se presenta el caso clínico, y una estrategia diagnóstica para pacientes con altas dosis de citarabina y compromiso pericárdico y miocárdico.

Summary Knowledge about cytarabine induced cardiotoxicity is scarce. We present the clinical case of a 51-year-old patient with past medical history of Acute Myeloid Leukemia managed with high doses of cytarabine and who developed acute myopericarditis as a complication. After support management in intensive care unit, specific cardioprotective heart failure therapy was started and, due to the high possibility of requiring high doses of cytarabine in subsequent oncological management, therapy with Non-Steroidal Anti-inflammatory drugs and colchicine was given to reduce the risk of myopericarditis recurrence. We present the clinical case and a diagnostic strategy for patients with high doses of cytarabine and pericardial and myocardial involvement.

Colchicine for pericarditis due to COVID-19: a case report

The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity.The most troublesome complication of acute pericarditis is the development of recurrent episodes of pericardial inflammation, occurring in 15% to 32% of cases. Therapeutic modalities are nonspecific and include non-steroidal anti-inflammatory drugs(NSAIDs) and corticosteroids. Here we present a case of a patient presenting with pericarditis due to COVID-19. He was successfully treated with colchicine. To our knowledge acute pericarditis due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)might be an under diagnosed condition in this pandemic. We want to share our findings, given the urgent need for different diagnostic and therapeutic strategies in order to better manage COVID-19 patients, and diminish the SARS-CoV-2 complications.

Pericarditis Aguda asociada a infección por COVID-19 / Acute pericarditis associated with COVID-19 infection

RESUMEN La infección por el coronavirus de tipo 2 causante del síndrome respiratorio agudo grave (SARS-COV2, por sus siglas en inglés), ha sido asociada con múltiples manifestaciones cardiovasculares. El mecanismo por el cual el virus afecta el corazón es objeto de discusión; sin embargo, se ha planteado que el receptor de la enzima convertidora de angiotensina (ACE2) sirve como entrada directa del virus. Así mismo, un estado de inflamación mediado por una tormenta de citoquinas puede generar falla multiorgánica y explicar algunas manifestaciones cardíacas. Las principales asociaciones al sistema cardiovascular reportadas en la infección por COVID-19 son el síndrome coronario agudo, la falla cardiaca aguda, el choque cardiogénico y las arritmias. La pericarditis aguda es un síndrome inflamatorio de etiología principalmente viral, pero su relación con la infección por SARS-COV2 parece ser infrecuente, con pocos reportes en la literatura. Se presenta el caso de una paciente que desarrolló pericarditis concomitante a la infección por SARS-COV2.

SUMMARY Infection by coronavirus type 2 that causes severe acute respiratory syndrome (SARS-CoV-2) has been associated with multiple cardiovascular manifestations. The mechanism by which the virus affects the heart is under discussion; however, it has been proposed that the angiotensinconverting enzyme 2 (ACE2) serves as a direct entry point for the virus; likewise, the state of inflammation mediated by cytokine storm can generate multiorgan failure, explaining some cardiac manifestations. The main associations to the cardiovascular system reported in COVID-19 infection are acute coronary syndrome, acute heart failure, cardiogenic shock and arrhythmias. Acute pericarditis is an inflammatory syndrome of mainly viral etiology, and its relationship to SARS-CoV-2 infection seems infrequent, with few reports in the literature. We present the case of a patient who developed pericarditis, concomitant with SARS-CoV-2 infection.

Pulmonary Embolism Initially Misdiagnosed as Perimyocarditis in a Young Pat?ent

EPulmonary embolism is a common cardiovascular emergency. In case of delayed diagnosis and treatment morbidity and mortality is high. In this report, we presented a case of pulmonary embolism without apparent risk factors, which was initially misdiagnosed as peri/myocarditis.

Signo de Spodick: ¿aliado o enemigo? / Spodick's sign: ally or enemy?

La pericarditis se refiere a la inflamación de las capas del pericardio y es la forma más común de enfermedad pericárdica. Puede estar asociada a derrame pericárdico y resultar en un taponamiento. La enfermedad puede ser una condición aislada o una manifestación cardíaca de un trastorno sistémico (por ejemplo, enfermedades autoinmunes o autoinflamatorias). La pericarditis se categoriza como aguda, incesante, recurrente o crónica, pero se debe tener en cuenta que también se clasifica como de etiología infecciosa y no infecciosa, siendo la presentación idiopática la más común

Pericarditis refers to inflammation of the layers of the pericardium and is the most common form of pericardial disease. It may be associated with pericardial effusion and result in tamponade. The disease may be an isolated condition or a cardiac manifestation of a systemic disorder (e.g., autoimmune or autoinflammatory diseases). Pericarditis is categorized as acute, incessant, recurrent, or chronic, but it should be noted that it is also classified as being of infectious and noninfectious etiology, with the idiopathic presentation being the most common

Chronic Expanding Hematoma with Constrictive Pericarditis / 日本心臓血管外科学会雑誌

We report the successful treatment of a rare case of chronic expanding hematoma and visceral pericardium thickening constrictive pericarditis with no history of trauma or surgery. A 70-year-old woman, who had no history of trauma or surgery was admitted for exertional dyspnea. An echocardiographic study demonstrated a mass located anterior to the right ventricle that severely compressed the right ventricle toward the ventricular septum. Enhanced chest computed tomography demonstrated pericardial calcification and a 125-mm heterogeneous mass in the middle mediastinum. A mosaic pattern was seen on T1, T2-weighted magnetic resonance imaging. Surgical resection of the mass and removal of the visceral pericardium were planned to treat heart failure and to confirm the diagnosis of the mass. The mass was old degenerated coagula. Histopathological examination confirmed the diagnosis of chronic expanding hematoma. The postoperative course was uneventful. There has been no sign of recurrence 19 months after the operation.

Pericardite tuberculosa em paciente imunocompetente: relato de caso / Tuberculous pericarditis in an immunocompetent patient: case report

A pericardite tuberculosa é uma forma rara de apresentação de tuberculose extrapulmonar, sendo mais frequente em regiões endêmicas e em pacientes imunocomprometidos. O quadro clínico é na maioria das vezes insidioso, por vezes com sintomas inespecíficos ou com quadro de tamponamento cardíaco. O diagnóstico é feito pela análise do líquido pericárdico ou biópsia pericárdica e o tratamento é realizado com rifampicina, isoniazida, pirazinamida e etambutol. O presente caso relata uma paciente de 51 anos, imunocompetente, com quadro de febre e dispneia há 7 dias. Em tomografia de tórax foi identificado importante derrame pericárdico, sem repercussão hemodinâmica em ecocardiografia transtorácica. A paciente foi submetida à drenagem do derrame pericárdico, com diagnóstico de tuberculose pericárdica pela análise do líquido. Iniciado o tratamento com RHZE, com boa evolução clínica e seguimento ambulatorial.

Tuberculous pericarditis is a rare form of extrapulmonary tuberculosis, being more frequent in endemic regions and in immunocompromised patients. The clinical picture is most often insidious, sometimes with nonspecific symptoms or with cardiac tamponade. Diagnosis is made by analysis of pericardial fluid or pericardial biopsy, and treatment is performed with rifampicin, isoniazid, pyrazinamide, and ethambutol. The present case reports a 51-year-old patient, immunocompetent, with fever and dyspnea for 7 days. A chest tomography showed significant pericardial effusion, without hemodynamic repercussions on transthoracic echocardiography. The patient underwent drainage of the pericardial effusion, with a diagnosis of pericardial tuberculosis by fluid analysis. Treatment with RHZE was started, with good clinical evolution and outpatient follow-up.

Síndrome de Dressler: el retorno de una enfermedad olvidada / Dressler's syndrome: the return of a forgotten entity

Resumen El síndrome de Dressler es una enfermedad infrecuente que fue descrita por primera vez en 1956 por el doctor William Dressler. Corresponde a un cuadro de pericarditis secundaria, en ocasiones asociada a efusión pericárdica de aparente etiología autoinmunitaria, que hace parte de los síndromes de lesión poscardiaca. Se presenta un caso de síndrome de Dressler en un paciente joven.

Abstract Dressler's syndrome is a rare entity which was first described in 1956 by Dr. William Dressler. It consists of secondary pericarditis, at times associated with pericardial effusion with an apparently autoimmune etiology, which is one of the post-cardiac injury syndromes. We present a case of Dressler's syndrome in a young patient.

Pericardial Effusion and Cardiac Tamponade: Etiology and Evolution in the Contemporary Era

Abstract Background: Pericardial effusion is a relatively common finding and can progress to cardiac tamponade; etiological diagnosis is important for guiding treatment decisions. With advances in medicine and improvement in the social context, the most frequent etiological causes have changed. Objectives: To evaluate the clinical and laboratory characteristics, etiology, and clinical course of patients with pericardial effusion and cardiac tamponade. Materials and methods: Patients with pericardial effusion classified as small (< 10 mm), moderate (between 10-20 mm), or severe (> 20 mm) were included. Data from the clinical history, physical examination, laboratory tests, and complementary tests were evaluated in patients with pericardial effusion and cardiac tamponade. The significance level was set at 5%. Results: A total of 254 patients with a mean age of 53.09 ± 17.9 years were evaluated, 51.2% of whom were female. A total of 40.4% had significant pericardial effusion (> 20 mm). Pericardial tamponade occurred in 44.1% of patients. Among pericardial effusion patients without tamponade, the most frequent etiologies were: idiopathic (44.4%) and postsurgical (17.6%), while among those with tamponade, the most frequent etiologies were postsurgical (21.4%) and postprocedural (19.6%). The mean follow-up time was 2.2 years. Mortality was 42% and 23.2 in those with and without tamponade, respectively (p=0.001). Conclusions: There is an etiological difference between pericardial effusion patients with and without cardiac tamponade. An idiopathic etiology is more common among those without tamponade, while postinterventional/postsurgical is more common among those with tamponade. The tamponade group had a higher mortality rate.

Miopericarditis aguda por Mycoplasma pneumonae en un niño de 5 años / Acute myopericarditis caused by Mycoplasma pneumonae in a 5 years old child

RESUMEN Las infecciones causadas por Mycoplasma pneumonae han sido reconocidas a nivel mundial y es un patógeno común de las infecciones de las vías respiratorias altas y bajas. La pericarditis aguda está a menudo acompañada por un grado de miocarditis y en la práctica clínica la pericarditis y miocarditis coexisten por su etiología en común y en su mayoría por virus cardiotrópos. A continuación, presentamos el caso muy poco común reportado de miopericarditis causada por Mycoplasma pneumonae en un niño de 5 años, con una evolución clínica interesante.

ABSTRACT Infections caused by Mycoplasma pneumoniae are well recognized all over the world, and this microorganism is a common pathogen affecting the lower respiratory tract. Acute pericarditis is often accompanied by myocarditis, and both conditions coexist in clinical practice because they have common etiologic agents, mainly cardiotropic viruses. We present a very unusual case of myopericarditis caused by Mycoplasma pneumoniae affecting a 5 year-old child, who developed an interesting clinical outcome.