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Reddy P, Kane GC, Oh JK, Luis SA. The Evolving Etiologic and Epidemiologic Portrait of Pericardial Disease. Can J Cardiol 2023; 39:1047-1058. [PMID: 37217161 DOI: 10.1016/j.cjca.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
Pericardial disease includes a variety of conditions, including inflammatory pericarditis, pericardial effusions, constrictive pericarditis, pericardial cysts, and primary and secondary pericardial neoplasms. The true incidence of this varied condition is not well established, and the causes vary greatly across the world. This review aims to describe the changing pattern of epidemiology of pericardial disease and to provide an overview of causative etiologies. Idiopathic pericarditis (assumed most often to be viral) remains the most common etiology for pericardial disease globally, with tuberculous pericarditis being most common in developing countries. Other important etiologies include fungal, autoimmune, autoinflammatory, neoplastic (both benign and malignant), immunotherapy-related, radiation therapy-induced, metabolic, postcardiac injury, postoperative, and postprocedural causes. Improved understanding of the immune pathophysiological pathways has led to identification and reclassification of some idiopathic pericarditis cases into autoinflammatory etiologies, including immunoglobulin G (IgG)4-related pericarditis, tumour necrosis factor receptor-associated periodic syndrome (TRAPS), and familial Mediterranean fever in the current era. Contemporary advances in percutaneous cardiac interventions and the recent COVID-19 pandemic have also resulted in changes in the epidemiology of pericardial diseases. Further research is needed to improve our understanding of the etiologies of pericarditis, using the assistance of contemporary advanced imaging techniques and laboratory testing. Careful consideration of the range of potential causes and local epidemiologic patterns of causality are important for the optimization of diagnostic and therapeutic approaches.
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Affiliation(s)
- Prajwal Reddy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Garvan C Kane
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jae K Oh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sushil Allen Luis
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
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Kane GC, Luis SA. Removing the Blindfold: Echo-Guidance for Pericardiocentesis. JACC Case Rep 2022; 5:101699. [PMID: 36636510 PMCID: PMC9830459 DOI: 10.1016/j.jaccas.2022.101699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Garvan C. Kane
- Address for correspondence: Dr Garvan C. Kane, Division of Cardiovascular Ultrasound, Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA. @garvankane
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Armstrong SM, Thavendiranathan P, Butany J. The pericardium and its diseases. Cardiovasc Pathol 2022. [DOI: 10.1016/b978-0-12-822224-9.00021-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Bush AL, Allencherril J, Alam M. Managing Thrombosis and Hemorrhage in a Man with Myocardial Infarction and Traumatic Hemopericardium with Cardiac Tamponade. Tex Heart Inst J 2021; 48:469062. [PMID: 34379771 DOI: 10.14503/thij-20-7308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 79-year-old man had an out-of-hospital acute ST-segment-elevation myocardial infarction with cardiac arrest. Cardiopulmonary resuscitation performed by a bystander resulted in traumatic hemopericardium. We discuss the patient's case, highlight the challenges of managing simultaneously life-threatening thrombosis and hemorrhage, and present our conclusions regarding the patient's eventual death.
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Affiliation(s)
- Aaron L Bush
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Joseph Allencherril
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Mahboob Alam
- Department of Cardiology, Texas Heart Institute, Houston, Texas.,Department of Cardiology, Baylor College of Medicine, Houston, Texas
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Valente T, Pignatiello M, Sica G, Bocchini G, Rea G, Cappabianca S, Scaglione M. Hemopericardium in the acute clinical setting: Are we ready for a tailored management approach on the basis of MDCT findings? LA RADIOLOGIA MEDICA 2020; 126:527-543. [PMID: 33136215 DOI: 10.1007/s11547-020-01303-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/20/2020] [Indexed: 11/26/2022]
Abstract
The clinical spectrum of pericardial effusions varies from innocuous serous fluid to life-threatening hemopericardium. A misdiagnosis may be made by similar clinical presentation of acute chest pain/hypotension. Echocardiography is the first-line test for diagnosis of pericardial effusion and its etiology, but sometimes there are different drawbacks to the correct cardiovascular ultrasound diagnosis. Radiologists are reporting an increasing amount of thoracic Multidetector CT examinations at the emergency department. Multidetector CT has now become an established and complementary method for cardiac imaging, and diseases of the pericardium can now be quickly identified with increasing certainty. The aim of this review is to discuss the hemopericardium key Multidetector CT features in acute clinical setting which indicate the need to proceed with predominantly medical or surgical treatment, however, being able to identify forms of bleeding pericardial effusion for which only "a watch and wait strategy" and/or deferred treatment is indicated. In the emergency care setting, radiologists must be aware of different findings of hemopericardium in order to address a tailored and timely management approach.
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Affiliation(s)
- Tullio Valente
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy.
| | - Maria Pignatiello
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Giacomo Sica
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
| | - Giorgio Bocchini
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
| | - Gaetano Rea
- Department of Diagnostic Imaging, Section of General Radiology, Azienda Ospedali dei Colli, Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Mariano Scaglione
- Department of Diagnostic Imaging, Pineta Grande Hospital, Castelvolturno, Italy
- Department of Radiology, Tesside University, Middlesbrough, UK
- James Cook University Hospital, Middlesbrough, UK
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Lyle MA, Wan SH, Miller FA. A 61-Year-Old Woman With New Pericardial Effusion. JAMA Cardiol 2020; 5:357-358. [PMID: 31968046 DOI: 10.1001/jamacardio.2019.5276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Melissa A Lyle
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Siu-Hin Wan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Fletcher A Miller
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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Ryu AJ, Kane GC, Pislaru SV, Lekhakul A, Geske JB, Luis SA, Michelena HI, Nkomo VT, Thaden JJ, Sinak LJ. Bleeding Complications of Ultrasound-Guided Pericardiocentesis in the Presence of Coagulopathy or Thrombocytopenia. J Am Soc Echocardiogr 2020; 33:399-401. [PMID: 31959530 DOI: 10.1016/j.echo.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Affiliation(s)
| | - Garvan C Kane
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sorin V Pislaru
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Annop Lekhakul
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Faculty of Medicine, Ramathibodhi Hospital, Mahidol University, Bangkok, Thailand
| | - Jeffrey B Geske
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sushil A Luis
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Hector I Michelena
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Vuyisile T Nkomo
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jeremy J Thaden
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Lawrence J Sinak
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
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