ABSTRACT
Heparin is a preferred initial anticoagulant in patients with new-onset atrial fibrillation (AF). Despite continuous debate about the risk, there has been a concern about heparin-induced hemorrhagic pericarditis and cardiac tamponade. We present a case of a new onset atrial fibrillation (AF) in a patient with renal impairment and evidence of pericardial effusion complicated by hemopericardium development after starting anticoagulation. Although the risk of hemorrhagic conversion of uremic pericarditis induced by heparin in ESRD patients with new onset AF was suggested in the literature, this case raises the possibility of a similar complication in dialysis-associated pericarditis. Therefore, we aim to heighten alertness regarding this potential complication of a commonly used medication in clinical practice. We also aim to review the current anticoagulation recommendations in this setting.
ABSTRACT
BACKGROUND: We used pericardioscope operation for a patient who suffered from subacute hemorrhagic pericarditis which usually have to had a sternotomy. CASE PRESENTATION: A pericardioscope was used in the operation rather than sternotomy on a 66-year-old male who was diagnosed with subacute hemorrhagic pericarditis after PCI(Percutaneous Coronary Intervention). He was discharged 7 days after the operation with an uneventfull postoperative course. CONCLUSIONS: We believe that this technique is a safe procedure without any major complications.
Subject(s)
Hemorrhage/surgery , Percutaneous Coronary Intervention/adverse effects , Pericarditis/surgery , Sternotomy/adverse effects , Aged , Echocardiography , Hemodynamics , Humans , Male , Postoperative Period , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
A 44-year-old woman with a history of factor V Leiden deficiency and recurrent pulmonary emboli was diagnosed with coronavirus disease 2019 (COVID-19) three weeks prior presented to her local ED with severe chest pain. She was found to have a large hemorrhagic pericardial effusion by cardiac MRI with echocardiographic signs of tamponade. She underwent the creation of a pericardial window and was treated with colchicine with improvement in symptoms.
ABSTRACT
The authors present a case of a 29-year-old woman who was diagnosed with pneumonia in the left side complicated with pleural effusion and hemorrhagic pericarditis one month after she had undergone tonsillectomy. Eikenella corrodens was identified as pathogenic agent when the empyema was removed during thoracotomy. After the patient was given antibiotic treatment she was discharged from the hospital without any symptoms or complaints. However, one month after she had left the hospital she was readmitted to the surgical unit as an emergency because of acute abdominal complaints. On admission acalculous cholecystitis as well as hemorrhagic pericarditis requiring pericardiocentesis were also observed. A rare cause of sepsis, Eikenella corrodens was identified which resulted in a severe disorder including polyserositis. Pericardiocentesis was performed two times and the patient was given targeted antibiotics and non-steroidal anti-inflammatory drugs. She was also treated with antimycotics as she had developed mycosis. After one month the patient recovered and was discharged from the hospital. No further recurrence of symptoms or complaints was observed during follow up.
Subject(s)
Acalculous Cholecystitis/diagnosis , Acalculous Cholecystitis/microbiology , Bacteremia/complications , Eikenella corrodens , Empyema, Pleural/microbiology , Gram-Negative Bacterial Infections/complications , Pericarditis/microbiology , Acalculous Cholecystitis/therapy , Adult , Anti-Bacterial Agents/therapeutic use , Bacteremia/diagnosis , Bacteremia/drug therapy , Bacteremia/microbiology , Drainage , Eikenella corrodens/isolation & purification , Empyema, Pleural/diagnosis , Empyema, Pleural/therapy , Female , Gram-Negative Bacterial Infections/diagnosis , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Hemorrhage/etiology , Hemorrhage/therapy , Humans , Pericardiocentesis , Pericarditis/complications , Pericarditis/diagnosis , Pericarditis/therapy , Thoracotomy , Tomography, X-Ray ComputedABSTRACT
Infective endocarditis is a disease that is characterized by the vegetations. Although cardiac complications remain the leading cause of death, endocarditis is complex, systemic illness with involvement of virtually all the organs. The spectrum and incidence of cardiovasular, neurologic, renal complications also are presented by direct embolism and immune- mediated phenomena. Systemic embolism is the common and serious complications associated with infective endocarditis. Mycotic aneurysm by septic embolization is known complication of bacterial endocarditis, but mycotic aneurysm of superior mesenteric artery is very rare complication and approximately 10 cases has been reported in the literature. Acute hemorrhagic pericarditis is unusual clinical manifestation of bacterial endocarditis and subject to catastrophic hemodynamic compromise secondary to cardiac tamponade. We report a case of bacterial endocarditis in 23 years old male who developed acute hemorrhagic pericarditis and hemoperitoneum due to rupture of mycotic aneurysm in superior mesenteric artery with brief review of lieratures.
