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Al-Yafeai Z, Sondhi M, Vadlamudi K, Vyas R, Nadeem D, Alawadi M, Carvajal-González A, Ghoweba M, Ananthaneni A. Novel anti-psoriasis agent-associated cardiotoxicity, analysis of the FDA adverse event reporting system (FAERS). Int J Cardiol 2024; 402:131819. [PMID: 38301830 DOI: 10.1016/j.ijcard.2024.131819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Psoriasis is a chronic skin condition characterized by hyperproliferation of epidermal keratinocytes, resulting in erythematous and scaling lesions. The US Food and Drug Administration (FDA) has approved nine biologic agents to address the burden of psoriasis, but their cardiovascular risks remain poorly studied. METHODS This retrospective pharmacovigilance study utilized the FDA Adverse Event Reporting System (FAERS) database to analyze adverse events associated with newly approved therapeutic agents for psoriasis. We employed disproportionally signal analysis, calculating the reporting odds ratio (ROR) with a 95% confidence interval. RESULTS Among the vast FAERS database, which contained >25 million adverse events, a total of 334,399 events were associated with newly approved therapeutic agents for psoriasis. Cardiac adverse events accounted for 3852 cases, including pericarditis, atrial fibrillation, and coronary artery disease. Secukinumab had the highest number of reported adverse events, followed by brodalumab, while tildrakizumab had the lowest. Coronary artery disease was the most reported adverse event (1438 cases), followed by pericarditis (572 cases) and atrial fibrillation (384 cases). Secukinumab had the highest incidence of coronary artery disease, pericarditis, and atrial fibrillation. Risankizumab was significantly associated with an increased risk of coronary artery disease and atrial fibrillation, while tildrakizumab and Ixekizumab were associated with atrial fibrillation. Secukinumab was associated with an elevated risk of pericarditis. CONCLUSIONS The study uncovers the cardiovascular adverse effects related to biologic agents used in psoriasis treatment. These findings emphasize the importance of monitoring and evaluating the cardiovascular safety profiles of biological agents used in psoriasis treatment.
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Affiliation(s)
- Zaki Al-Yafeai
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA; Division of Cardiology, Department of Medicine, College of Medicine, University of Illinois at Chicago.
| | - Manush Sondhi
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Kavya Vadlamudi
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Rahul Vyas
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Daniyal Nadeem
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | | | | | - Mohamed Ghoweba
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
| | - Anil Ananthaneni
- Department of Internal Medicine, LSUHSC-Shreveport, Shreveport, USA
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2
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Collini V, Andreis A, De Biasio M, De Martino M, Isola M, Croatto N, Lepre V, Cantarini L, Merlo M, Sinagra G, Abbate A, Lazaros G, Brucato A, Klein AL, Imazio M. Efficacy of colchicine in addition to anakinra in patients with recurrent pericarditis. Open Heart 2024; 11:e002599. [PMID: 38490715 PMCID: PMC10946365 DOI: 10.1136/openhrt-2023-002599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024] Open
Abstract
AIM Anakinra, an anti IL-1 agent targeting IL-1 alfa and beta, is available for the treatment of recurrent pericarditis in cases with corticosteroid dependence and colchicine resistance after failure of conventional therapies. However, it is unclear if the combination with colchicine, a non-specific inhibitor of the inflammasome targeting the same inflammatory pathway of IL-1, could provide additional benefit to prevent further recurrences. The aim of the present observational study is to assess whether the addition of colchicine on top of anakinra could prolong the time to first recurrence and prevent recurrences better than anakinra alone. METHODS International, all-comers, multicentre, retrospective observational cohort study analysing all consecutive patients treated with anakinra for corticosteroid-dependent and colchicine-resistant recurrent pericarditis. The efficacy endpoint was recurrence rate and the time to the first recurrence. RESULTS A total of 256 patients (mean age 45.0±15.4 years, 65.6% females, 80.9% with idiopathic/viral aetiology) were included. 64 (25.0%) were treated with anakinra as monotherapy while 192 (75.0%) with both anakinra and colchicine. After a follow-up of 12 months, 56 (21.9%) patients had recurrences. Patients treated with colchicine added to anakinra had a lower incidence of recurrences (respectively, 18.8% vs 31.3%; p=0.036) and a longer event-free survival (p=0.025). In multivariable analysis, colchicine use prevented recurrences (HR 0.52, 95% CI 0.29 to 0.91; p=0.021). CONCLUSIONS The addition of colchicine on top of anakinra treatment could be helpful to reduce recurrences and prolong the recurrence-free survival.
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Affiliation(s)
- Valentino Collini
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandro Andreis
- Division of Cardiology, Department of Medical Sciences, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, University of Torino, Torino, Italy
| | - Marzia De Biasio
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Maria De Martino
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Miriam Isola
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Nicole Croatto
- Department of Medicine (DMED), University of Udine, Udine, Italy
| | - Veronica Lepre
- Cardiology Specialty School, University of Trieste, Trieste, Italy
| | | | - Marco Merlo
- Cardiology Specialty School, University of Trieste, Trieste, Italy
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
| | - Gianfranco Sinagra
- Cardiology Specialty School, University of Trieste, Trieste, Italy
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
| | - Antonio Abbate
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - George Lazaros
- Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Athens, Greece
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences "Sacco", University of Milano, Milano, Italy
| | - Allan L Klein
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Massimo Imazio
- Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DMED), University of Udine, Udine, Italy
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Mascarenhas L, Agakishiev D, Freeman M, Hubers S. Purulent pericarditis caused by methicillin-sensitive Staphylococcus aureus bacteriuria. BMC Cardiovasc Disord 2024; 24:154. [PMID: 38481129 PMCID: PMC10935777 DOI: 10.1186/s12872-024-03828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/04/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Purulent pericarditis (PP)- a purulent infection involving the pericardial space-requires a high index of suspicion for diagnosis as it often lacks characteristic signs of pericarditis and carries a mortality rate as high as 40% even with treatment. Common risk factors include immunosuppression, diabetes mellitus, thoracic surgery, malignancy, and uremia. Most reported cases of PP occur in individuals with predisposing risk factors, such as immunosuppression, and result from more commonly observed preceding infections, such as pneumonia, osteomyelitis, and meningitis. We report a case of PP due to asymptomatic bacteriuria in a previously immunocompetent individual on a short course of high-dose steroids. CASE PRESENTATION An 81-year-old male presented for severe epigastric pain that worsened with inspiration. He had been on high-dose prednisone for presumed inflammatory hip pain. History was notable for urinary retention requiring intermittent self-catheterization and asymptomatic bacteriuria and urinary tract infections due to methicillin-sensitive Staphylococcus aureus (MSSA). During the index admission he was found to have a moderate pericardial effusion. Pericardial fluid cultures grew MSSA that had an identical antibiogram to that of the urine cultures. A diagnosis of purulent pericarditis was made. CONCLUSION PP requires a high index of suspicion, especially in hosts with atypical risk factors. This is the second case of PP occurring as a result of asymptomatic MSSA bacteriuria. Through reporting this case we hope to highlight the importance of early recognition of PP and the clinical implications of asymptomatic MSSA bacteriuria in the setting of urinary instrumentation and steroid use.
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Affiliation(s)
- Lorraine Mascarenhas
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Dzhalal Agakishiev
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Morgan Freeman
- Gastroenterology Division, University of Minnesota, Minneapolis, MN, USA
| | - Scott Hubers
- Cardiology Division, Veterans Affairs Medical Center, Minneapolis, MN, USA
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Abstract
Pericarditis typically presents with classic symptoms of acute sharp, retrosternal, and pleuritic chest pain. It can have several different underlying causes including viral, bacterial, and autoimmune etiologies. The mainstays of pericarditis treatment are nonsteroidal anti-inflammatory drugs and colchicine with glucocorticoids or other immunosuppressive drugs used for refractory cases and relapse. Myocarditis is an inflammatory disease of the cardiac muscle that is caused by a variety of infectious and noninfectious conditions. It mainly affects young adults (median age 30-45 years), and men more than women. The clinical manifestations of myocarditis are highly variable, so a high level of suspicion in the early stage of disease is important to facilitate diagnosis. The treatment of myocarditis includes nonspecific treatment aimed at complications such as heart failure and arrhythmia, as well as specific treatment aimed at underlying causes. Pericarditis and myocarditis associated with vaccine have been extremely rare before coronavirus disease 2019 (COVID-19). There is a small increase of incidence after COVID-19 messenger ribonucleic acid vaccine, but the relative risk for pericarditis and myocarditis due to severe acute respiratory syndrome coronavirus 2 infection is much higher. Therefore, vaccination against COVID-19 is currently recommended for everyone aged 6 years and older.
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Affiliation(s)
- Philip Hunter Spotts
- Department of Family Medicine & Community Health, Duke Student Health, Duke University, 305 Towerview Road, Second Floor, Durham, NC 27708, USA.
| | - Fan Zhou
- Department of Family Medicine & Community Health, Duke Student Health, Duke University, 305 Towerview Road, Second Floor, Durham, NC 27708, USA
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Rosseel T, Van Puyvelde T, Pauwelyn M, L'Hoyes W, Frederiks P, Desmet W. Bacterial pericarditis due to an esophagopericardial fistula. Acta Cardiol 2024; 79:79-80. [PMID: 37581319 DOI: 10.1080/00015385.2023.2246010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/03/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Thomas Rosseel
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Tim Van Puyvelde
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Maarten Pauwelyn
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Wouter L'Hoyes
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Pascal Frederiks
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Walter Desmet
- Department of Cardiovascular Diseases, University Hospitals Leuven, Leuven, Belgium
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María PLE, Diego RS, Jorge NR. Myocarditis and Pericarditis Related to mRNA COVID-19 Vaccination: A Case Report. Curr Drug Saf 2024; 19:154-158. [PMID: 36999413 DOI: 10.2174/1574886318666230329123459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Reported cases after the post-commercialization phase of mRNA vaccines against COVID-19 have revealed that myocarditis and pericarditis may occur predominantly in male adolescents after the second dose of the vaccine. CASE PRESENTATION We report two cases of cardiac disorders associated with mRNA COVID-19 vaccination, both of them in 15 year-old males. One of the patients presented acute pericarditis and the second one presented acute myocarditis with left ventricular dysfunction at hospital discharge. DISCUSSION AND CONCLUSION Physicians should be aware with the typical manifestations of these cardiovascular events after the vaccination and report suspicious cases to pharmacovigilance agencies as soon as possible. The population should rely on the pharmacovigilance system that continues to recommend vaccination as the most effective strategy to reduce the negative consequences of the pandemic.
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Affiliation(s)
| | - Rangel Sousa Diego
- Cardiology Department, Virgen del Rocío University Hospital, Seville, Spain
| | - Navarro Roldán Jorge
- Clinical Pharmacology Department, Virgen del Rocío University Hospital, Seville, Spain
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Dvoretsky LI, Rachina SA, Poltavskaya MG, Andreev DA, Tarykina EV, Plaksina NA, Minaev VV, Terekhova AV. [Exudative pericarditis with tamponade after COVID-19. Case report]. TERAPEVT ARKH 2023; 95:965-969. [PMID: 38158953 DOI: 10.26442/00403660.2023.11.202475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
A description of a COVID-19 patient with the development of exudative pericarditis complicated by cardiac tamponade is provid. A peculiarity of this case is the presence of an underlying disease in the patient (chronic lymphocytic leukemia), which was in remission for 1.5 years after chemotherapy. Another feature of the patient was the relatively small area of lung damage and the hemorrhagic nature of the pericardial effusion, which persisted for a long time. The insignificant activity of inflammatory markers was noteworthy. Possible mechanisms of development and features of the course of exudative pericarditis in the described patient, issues of diagnosis and treatment of this category of patients are discusse.
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Affiliation(s)
- L I Dvoretsky
- Sechenov First Moscow State Medical University (Sechenov University)
| | - S A Rachina
- Sechenov First Moscow State Medical University (Sechenov University)
| | - M G Poltavskaya
- Sechenov First Moscow State Medical University (Sechenov University)
| | - D A Andreev
- Sechenov First Moscow State Medical University (Sechenov University)
| | | | - N A Plaksina
- Sechenov First Moscow State Medical University (Sechenov University)
| | - V V Minaev
- Sechenov First Moscow State Medical University (Sechenov University)
| | - A V Terekhova
- Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine
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8
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Martínez-Mata LA, Ledesma-Ramírez SA, Ramos-Ramos X. [Clinical features of pericarditis in patients with SARS-CoV-2]. Rev Med Inst Mex Seguro Soc 2023; 61:S269-S274. [PMID: 38016123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/16/2023] [Indexed: 11/30/2023]
Abstract
Background COVID-19 disease (coronavirus disease 2019) has multiple potentially fatal cardiovascular complications and pericarditis is one of them; however, if prompt treatment is given, fatal events associated to this complication decrease. Its frequency and presentation characteristics are unknown, which is why its early diagnosis is important. Objective To know the frequency of pericarditis secondary to COVID-19 and its presentation characteristics. Material and methods Cross-sectional study in patients with a diagnosis of pericarditis after COVID-19 disease (with a positive test). Symptoms, age, sex, comorbidities, and electrocardiogram (ECG) and transthoracic echocardiogram (TTE) results were obtained. Results A total of 3364 patients positive for COVID-19 were registered, out of which 10 met criteria for pericarditis, which represented a frequency of 0.30%. The average age of the sample was 46.1 years and 60% predominated in the male gender with a 1.5:1 ratio. The most frequent clinical characteristics were the presence of retrosternal pain (90%), absence of comorbidity (50%), and absence of electrocardiographic changes (40%). Conclusions Pericarditis has a low frequency in patients with COVID-19. The predominant clinical presentation is chest pain. Almost half will not have electrocardiographic changes, and half will not have comorbidities.
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Affiliation(s)
- Luis Alonso Martínez-Mata
- Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Dirección de Educación e Investigación en Salud. León, Guanajuato, México
| | - Silvia Amparo Ledesma-Ramírez
- Instituto Mexicano del Seguro Social, Hospital General de Zona con Medicina Familiar No. 3, Servicio de Cardiología. Salamanca, Guanajuato, México
| | - Xóchitl Ramos-Ramos
- Instituto Mexicano del Seguro Social, Órgano de Operación Administrativa Desconcentrada Guanajuato, Coordinación Auxiliar Médica de Investigación en Salud
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9
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Littmann L. Thyrotoxic Pericarditis. Am J Med 2023; 136:1165-1168. [PMID: 37696348 DOI: 10.1016/j.amjmed.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Affiliation(s)
- Laszlo Littmann
- Department of Internal Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC.
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10
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Zafar W, Ahmed M, Zafar M. Comment on: Acute Myocarditis and Pericarditis After mRNA COVID-19 Vaccinations: A Single-Centre Retrospective Analysis. Curr Probl Cardiol 2023; 48:101860. [PMID: 37295634 PMCID: PMC10246300 DOI: 10.1016/j.cpcardiol.2023.101860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
We have thoroughly reviewed the research conducted by Marina et al., titled "Acute Myocarditis and Pericarditis After mRNA COVID-19 Vaccinations—A Single-Centre Retrospective Analysis" [1]. We commend the authors for their diligent work in presenting a concise and informative report. While we agree with the overall findings of the study, which indicate a moderate risk of myopericarditis following mRNA COVID-19 vaccinations, particularly among young males, we would like to draw attention to several areas where the conclusion could have been strengthened. Firstly, it is crucial to acknowledge that retrospective studies possess inherent limitations such as recollection bias and potential inaccuracies in patient documentation. These issues could have been mitigated by including actual cases from the relevant period. Additionally, conducting the study across multiple hospitals or utilizing national databases would have helped address any bias arising from distinct socioeconomic, health, and environmental factors [2].
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Affiliation(s)
- Wirda Zafar
- Department of Medicine, University of Medicine and health Sciences St. Kitts, New York, NY.
| | - Muhammad Ahmed
- Department of Medicine, American University of the Carribean
| | - Mahrukh Zafar
- Department of Medicine, University of Medicine and health sciences
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Said M, Gouvoussis N, Tong J. First nations infant with complex invasive group A Streptococcal disease with pericarditis. J Paediatr Child Health 2023; 59:1323-1326. [PMID: 37814932 DOI: 10.1111/jpc.16503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/16/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Mirvat Said
- Department of General Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Nikki Gouvoussis
- Department of General Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- School of Medicine, The University of Notre Dame, Sydney, New South Wales, Australia
| | - James Tong
- Department of General Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of General Paediatrics, The Sutherland Hospital and Community Health Service, Sydney, New South Wales, Australia
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12
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Jawahar AP, Thattaliyath B, Badheka A, Chegondi M. Histoplasma associated pericarditis with pericardial tamponade in a child. BMJ Case Rep 2023; 16:e256265. [PMID: 37996150 PMCID: PMC10668139 DOI: 10.1136/bcr-2023-256265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
Histoplasma-mediated pericarditis is rare, and it occurs due to host-mediated inflammatory or immune response to adjacent mediastinal adenitis or pneumonitis. It is usually self-limited and rarely progresses to a disseminated infection in an immunocompetent individual. In rare instances, it can occur without pulmonary manifestations, making the diagnosis challenging given the broad list of differentials that can be considered as in our patient who initially presented with an isolated pericardial effusion with tamponade needing emergent pericardiocentesis.
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Affiliation(s)
- Aravinth Prasanth Jawahar
- Pediatric Critical Care Medicine, The University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
| | - Bijoy Thattaliyath
- Division of Pediatric Cardiology, The University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
| | - Aditya Badheka
- Pediatric Critical Care Medicine, The University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
| | - Madhuradhar Chegondi
- Pediatric Critical Care Medicine, The University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
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13
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Wong JW, Bock E, Kee WS, Anderson AJ, Kothari D, Tarca AJ. Myopericarditis following COVID-19 vaccination in adolescent triplets. Cardiol Young 2023; 33:2379-2383. [PMID: 37154289 DOI: 10.1017/s1047951123001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Multiple studies have reported myocarditis and pericarditis after the Pfizer-BioNTech coronavirus disease 2019 messenger ribonucleic acid vaccine. We describe male adolescent triplets who presented with myopericarditis within one week following vaccine administration.
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Affiliation(s)
- Jessica W Wong
- Emergency Department, Perth Children's Hospital, Perth, Australia
| | - Erin Bock
- Emergency Department, Perth Children's Hospital, Perth, Australia
| | - Wooi Seng Kee
- Department of Cardiology, Children's Cardiac Centre, Perth Children's Hospital, Perth, Australia
| | - Aleisha J Anderson
- Department of Infectious Diseases, Perth Children's Hospital, Perth, Australia
| | - Darshan Kothari
- Department of Cardiology, Children's Cardiac Centre, Perth Children's Hospital, Perth, Australia
| | - Adrian J Tarca
- Department of Cardiology, Children's Cardiac Centre, Perth Children's Hospital, Perth, Australia
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14
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Brosilow S, Zaid WA, Maghen D, Khoury A, Aharonson D, Lorber A. Do quantitative levels of cardiac troponin I implicate on severity of disease in children, adolescences, and young adults with acute myocarditis and myopericarditis? Cardiol Young 2023; 33:2315-2318. [PMID: 36744328 DOI: 10.1017/s1047951123000136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES When cardiac muscle damage occurs, cardiac troponins are released to blood and their detection is used as a marker in clinical setting. The prognostic value of the quantitative levels of blood troponin I in cases of myocarditis and myopericarditis is unclear. The aim of this study was to analyse whether troponin quantitative blood levels can be correlated with the course of hospitalisation and prognosis. METHODS Retrospective data was collected from all consecutive patients aged ≤30 hospitalised with a diagnosis of acute myocarditis or acute myopericarditis in our health Care Campus between the years 2010-2016. RESULTS Ninety-three patients with myocarditis and myopericarditis were identified. Higher peak troponin levels correlated with longer hospitalisation times in the cardiac or paediatric wards (p = 0.03, Pearson correlation: r -0.23), and median troponin level at admission correlated with longer overall hospitalisation (p = 0.026, Pearson correlation: r = 0.23). Patients admitted to ICU, received oral cardiac supportive therapy or that were discharged with cardiac drugs had higher median troponin compared to patients who were not but this was not statistically significant. A small group of patients that needed intravenous cardiac support had significantly lower median peak troponin levels (n = 4, 0.375ng/ml, p = 0.048). Only two patients needed extracorporeal membrane oxygenation support, and one died. The small number of patients precludes statistical analysis. CONCLUSION Higher troponin levels correlated significantly with longer hospitalisation, lower troponin values correlated with intravenous cardiac support, while other variables related to the severity of disease could not be significantly related to higher troponin levels.
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Affiliation(s)
- Sharon Brosilow
- Pediatric Cardiology & Congenital Heart Disease in Adults, The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Wisam Abo Zaid
- Pediatric Cardiology & Congenital Heart Disease in Adults, The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daniel Maghen
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Asaad Khoury
- Pediatric Cardiology & Congenital Heart Disease in Adults, The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Doron Aharonson
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Cardiac Intensive Care, Cardiology Unit, Rambam Health Care Campus, Haifa, Israel
| | - Avraham Lorber
- Pediatric Cardiology & Congenital Heart Disease in Adults, The Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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15
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Diodato S, Bardacci Y, El Aoufy K, Belli S, Bambi S. Early myopericarditis diagnosed in a 31-year-old patient using smartwatch technology: A case report. Int Emerg Nurs 2023; 71:101365. [PMID: 37797416 DOI: 10.1016/j.ienj.2023.101365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/06/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION Smartwatches, wrist-mounted devices with computing capacity able to connect with other devices via short-range wireless networking, are today commonly used by the general population to monitor their health status using specific applications. Currently, these devices offer new possibilities in remote health care monitoring and integration with other applications, through alert notifications, collection of personal data by a variety of sensors and the storage of these data. Several companies are introducing smartwatches with "health status" monitoring software with multiple functions, i.e. electrocardiogram (ECG) sensors. Recently, detection of atrial fibrillation based on heart rate monitoring by optical sensors resulted to be feasible and reliable when using the Apple Watch® and its corresponding application. Indeed, previous case reports highlighted its sensitivity in detecting morphological changes typical of the Acute Coronary Syndrome. CASE REPORT We report the case of a healthcare worker, who experienced chest pain and diffuse myalgia, detected ECG alterations in the ST segment, and reached the Emergency Department Myopericarditis was diagnosed and treated promptly to prevent complications. DISCUSSION Acute viral myocarditis and pericarditis are clinical conditions, usually characterized by 21 a benign course that does not require medical evaluation. However, ventricular arrhythmias are also common in viral myocarditis, and the latter is associated with a large proportion of sudden cardiac deaths in the young population without previous structural heart disease. In this case report, smartwatch technology allowed the preventive implementation of interventions against potentially life-threatening complications. Further developments in smartwatch technology could lead to more sensitive and specific diagnostic algorithms for conditions that require immediate medical intervention.
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Affiliation(s)
- Samuele Diodato
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, Florence, Italy
| | - Yari Bardacci
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, Florence, Italy.
| | - Khadija El Aoufy
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Simone Belli
- Emergency and Trauma Intensive Care Unit, Careggi University Hospital, Florence, Italy
| | - Stefano Bambi
- Department of Health Science, University of Florence, Italy
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16
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Zuin M, Imazio M, Rigatelli G, Pasquetto G, Bilato C. Risk of incident pericarditis after coronavirus disease 2019 recovery: a systematic review and meta-analysis. J Cardiovasc Med (Hagerstown) 2023; 24:822-828. [PMID: 37695617 DOI: 10.2459/jcm.0000000000001536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
AIMS Data regarding the risk of incident pericarditis in coronavirus disease 2019 (COVID-19) recovered patients are lacking. We determined the risk of incident pericarditis after COVID-19 infection by performing a systematic review and meta-analysis of available data. METHODS Following the PRISMA guidelines, we searched MEDLINE and Scopus to locate all articles published up to 11 February 2023 reporting the risk of incident pericarditis in patients who had recovered from COVID-19 infection compared to noninfected patients (controls) defined as those who did not experience the disease over the same follow-up period. Pericarditis risk was evaluated using the Mantel-Haenszel random effects models with hazard ratio (HR) as the effect measure with 95% confidence interval (CI) while heterogeneity was assessed using Higgins I2 statistic. RESULTS Overall, 16 412 495 patients (mean age 55.1 years, 76.8% males), of whom 1 225 715 had COVID-19 infection, were included. Over a mean follow-up of 9.6 months, pericarditis occurred in 3.40 (95% CI: 3.39-3.41) out of 1000 patients who survived COVID-19 infection compared with 0.82 (95% CI: 0.80-0.83) out of 1000 control patients. Recovered COVID-19 patients presented a higher risk of incident pericarditis (HR: 1.95, 95% CI: 1.56-2.43, I2 : 71.1%) compared with controls. Meta-regression analysis showed a significant direct relationship for the risk of incident pericarditis using HT ( P = 0.02) and male sex ( P = 0.02) as moderators, while an indirect association was observed when age ( P = 0.01) and the follow-up length ( P = 0.02) were adopted as moderating variables. CONCLUSIONS Recovered COVID-19 patients have a higher risk of pericarditis compared with patients from the general population.
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Affiliation(s)
- Marco Zuin
- Department of Translational Medicine, University of Ferrara, Ferrara
- Department of Cardiology, West Vicenza Hospital, Arzignano, Italy
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital Santa Maria della Misericordia, and University of Udine, Udine
| | | | | | - Claudio Bilato
- Department of Cardiology, West Vicenza Hospital, Arzignano, Italy
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17
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Salimi M, Davoodi L, Jalalian R, Darayee M, Moslemi A, Faeli L, Mirzakhani R, Shokohi T. A fatal Candida albicans pericarditis presenting with cardiac tamponade after COVID-19 infection and cardiothoracic surgery. J Clin Lab Anal 2023; 37:e24968. [PMID: 37803881 PMCID: PMC10681509 DOI: 10.1002/jcla.24968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 08/08/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Candida pericardial infection is a rare clinical entity usually related to recent cardiothoracic surgery and chronic debilitating conditions. During the COVID-19 pandemic, invasive fungal infections have been on the rise, likely due to a combination of factors such as immunosuppression, underlying conditions like diabetes, and surgical procedures. CASE PRESENTATION Herein, we report a 67-year-old diabetic woman with a history of COVID-19 infection who received a high dose of corticosteroids a few months before admission, and previous myocardial infarction for more than 12 years. The patient had a positive cardiac tamponade with signs of dyspnea, chest pain, and low blood pressure. Echocardiographic data were more in favor of constrictive pericarditis. The patient underwent urgent echocardiography-guided pericardiocentesis and then broad-spectrum antibiotic treatment was prescribed. Repeated echocardiography implied a persistent pericardial effusion 10 days later. Subxiphoid aspirates and biopsied tissues showed budding yeast cells and yeast colonies grew on culture media identified as Candida albicans. CONCLUSION This report should bring to the attention of physicians toward the possibility of Candida pericardial infection presenting with cardiac tamponade after COVID-19 infection and cardiothoracic surgery. Echocardiographic assessment, prompt pericardiotomy, molecular-based identification of causative agent, and early administration of appropriate antifungal treatment should improve the patient's survival.
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Affiliation(s)
- Maryam Salimi
- Student Research CommitteeMazandaran University of Medical SciencesSariIran
| | - Lotfollah Davoodi
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Rozita Jalalian
- Department of Cardiology, School of Medicine, Cardiovascular Research CenterMazandaran University of Medical SciencesSariIran
| | - Masood Darayee
- Department of Cardiac Surgery, School of Medicine, Cardiovascular Research CenterMazandaran University of Medical SciencesSariIran
| | - Azam Moslemi
- Student Research CommitteeMazandaran University of Medical SciencesSariIran
| | - Leyla Faeli
- Student Research CommitteeMazandaran University of Medical SciencesSariIran
| | | | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariIran
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18
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Pryor K, Tarter L, Economy K, Honigberg MC, Valente AM, Garshick M, Weber B. Pericarditis Management in Individuals Contemplating Pregnancy, Currently Pregnant, or Breastfeeding. Curr Cardiol Rep 2023; 25:1103-1111. [PMID: 37632607 PMCID: PMC10872603 DOI: 10.1007/s11886-023-01930-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE OF REVIEW Pericarditis complicates pregnancy planning, pregnancy, or the postpartum period, and the management approach requires special considerations. Here, we aim to summarize the latest research, diagnostic, and treatment strategies. RECENT FINDINGS Physiologic cardiovascular (CV) adaptations occurring during pregnancy complicate diagnosis, but for most patients, an electrocardiogram (ECG) and transthoracic echocardiogram (TTE) are sufficient to diagnosis pericarditis in the appropriate clinical context. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) can be used until 20 weeks gestation as needed. The use of colchicine is encouraged at any time point to reduce the risk of recurrence. Glucocorticoids may be used at the lowest possible dose for the least amount of time throughout pregnancy and breastfeeding. For incessant, recurrent, or refractory pericarditis, or when the above therapies are contraindicated, there may be a consideration of the use of IL-1 inhibition during pregnancy, recognizing the limited data in pregnant patients. Finally, we encourage the use of a multidisciplinary team approach including OB-GYN, cardiology, and rheumatology when available. The diagnosis and treatment of pericarditis in female patients of reproductive age require special considerations. Although highly effective treatment options are available, there is a need for greater data and larger international registries to improve treatment recommendations.
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Affiliation(s)
- Katherine Pryor
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Laura Tarter
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Katherine Economy
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael C Honigberg
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Anne Marie Valente
- Boston Children's Hospital, Boston, MA, USA
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA
| | - Michael Garshick
- Leon H. Charney Division of Cardiology, Department of Medicine, New York University Langone Health, NYU Grossman School of Medicine, New York, NY, 10016, USA
- Ronald O. Perelman Department of Dermatology, New York University Langone Health, NYU Grossman School of Medicine, New York, NY, 10016, USA
| | - Brittany Weber
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA.
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19
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Wu MA, Bizzi E, Brucato A. Inflammatory puzzle: Unveiling the role of D-Dimer in acute pericarditis and thromboinflammation. Eur J Intern Med 2023; 116:41-42. [PMID: 37507266 DOI: 10.1016/j.ejim.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Maddalena Alessandra Wu
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy.
| | - Emanuele Bizzi
- Division of Internal Medicine, ASST Fatebenefratelli Sacco, Fatebenefratelli Hospital, University of Milan, Milan, Italy
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences, University of Milan, Fatebenefratelli Hospital, Milan, Italy
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20
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Lazaros G, Vlachakis PK, Theofilis P, Dasoula FE, Imazio M, Lazarou E, Vlachopoulos C, Tsioufis C. D-dimer as a diagnostic and prognostic plasma biomarker in patients with a first episode of acute pericarditis. Eur J Intern Med 2023; 116:58-64. [PMID: 37357033 DOI: 10.1016/j.ejim.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/07/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES The impact of plasma biomarkers on diagnosis and prognosis of patients with acute pericarditis (AP) has been poorly investigated. This study aims to assess the diagnostic and prognostic role of d-dimer (DD), an easily obtainable biomarker, in patients with AP. PATIENTS AND METHODS This is a prospective clinical study enrolling 265 consecutive patients hospitalized between September 2010 and May 2019 with a first episode of AP. At baseline, demographics, clinical features, laboratory and imaging findings were recorded. All patients were followed-up for a minimum of 18 months. Endpoints included cardiac tamponade, new-onset atrial fibrillation, pericardial drainage, recurrent/constrictive pericarditis and death. RESULTS DD was measured in 165 out of 265 patients (62.3%, median levels 1456 ng/mL) Among them, 121 patients (73.3%) presented with elevated age-adjusted DD levels. Patients with elevated DD depicted a higher rate of pleural (69.4%, vs 38.6%, p<0.001) and pericardial effusions (89.3% vs 72.7%, p = 0.009). Elevated DD correlated with admission (rho=0.37) and peak (rho=0.36) C-reactive protein values. Patients with elevated DD depicted a trend towards a greater prevalence of pericardial tamponade vs those without (14.9% vs 4.5% respectively, p = 0.07). In the 43.8% of patients with elevated DD who underwent computed tomography pulmonary angiography (CTPA), no case of pulmonary embolism or aortic syndrome was unveiled. CONCLUSION DD elevation is detected in the majority of AP cases at presentation and may herald cardiac tamponade. In patients with chest pain not attributable to alternative causes, elevated DD denotes an inflammatory condition and should not prompt unnecessary investigations, such as CTPA.
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Affiliation(s)
- George Lazaros
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece.
| | - Panagiotis K Vlachakis
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece
| | - Panagiotis Theofilis
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece
| | - Foteini E Dasoula
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, University Hospital "Santa Maria della Misericordia", ASUFC, Udine, Italy
| | - Emilia Lazarou
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece
| | - Charalambos Vlachopoulos
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece
| | - Costas Tsioufis
- First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Vas. Sofias 114, Athens 11527, Greece
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21
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Bristowe H, Day M, Fifer H, Arias M. Gonococcal pericarditis with tamponade - use of molecular technology to improve diagnosis and management. Int J Infect Dis 2023; 134:150-152. [PMID: 37329948 DOI: 10.1016/j.ijid.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023] Open
Abstract
We report a case of gonococcal pericarditis, which was unexpected due to its extremely unusual occurrence. A 42-year-old man presented with fever, chest pain, dyspnea, and tachycardia. He was initially stable but rapidly deteriorated, developing pericardial effusion with tamponade requiring a pericardial window. Incompletely decolorized gram stain of the pericardial fluid initially suggested the presence of gram-positive diplococci, which wrongly directed treatment toward possible pneumococcal infection. Because cultures were negative, identification of the causative organism was attempted by molecular and genotyping analysis. These techniques identified Neisseria gonorrhoeae-multi-antigen sequence type 14994 (por 5136/tbpB 33) as the etiology, which has been associated with disseminated gonococcal disease. Real-time polymerase chain reaction showed no evidence of mutations within the N. gonorrhoeae penA gene responsible for causing ceftriaxone resistance. This was crucial in guiding antibiotic treatment, in light of the high prevalence of multi-drug-resistant N. gonorrhoeae. This case highlights the utility of diagnostic molecular techniques in identifying N. gonorrhoeae as the etiology of an exceedingly rare case of pericarditis.
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Affiliation(s)
- Henrietta Bristowe
- Department of Infection Sciences, King's College Hospital, Denmark Hill, SE5 9RS, London, UK
| | - Michaela Day
- UK Health Security Agency, Colindale, London, UK
| | - Helen Fifer
- UK Health Security Agency, Colindale, London, UK
| | - Mauricio Arias
- Department of Infection Sciences, King's College Hospital, Denmark Hill, SE5 9RS, London, UK.
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22
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Midey C, Philippart F. An acute chest pain revealing an inflammatory pericarditis. Intensive Care Med 2023; 49:1131-1132. [PMID: 37418040 DOI: 10.1007/s00134-023-07151-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
Affiliation(s)
- Charlotte Midey
- Cardiology Department, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - François Philippart
- Medical and Surgical Intensive Care Department, Groupe Hospitalier Paris Saint Joseph, 185 Rue R. Losserand 75014, Paris, France.
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23
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Louie G, Torres R, Katelaris AL, McGregor C, Lai V, Stevens R, Sullivan R, Konecny P. Meningococcal B septic shock, reactive pericarditis and public health. Med J Aust 2023; 219:150-152. [PMID: 37474130 DOI: 10.5694/mja2.52049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Gary Louie
- South Eastern Sydney Local Health District, Sydney, NSW
- University of New South Wales, Sydney, NSW
| | - Romeo Torres
- South Eastern Sydney Local Health District, Sydney, NSW
| | | | | | - Victor Lai
- South Eastern Sydney Local Health District, Sydney, NSW
- University of New South Wales, Sydney, NSW
| | - Robert Stevens
- South Eastern Sydney Local Health District, Sydney, NSW
- University of New South Wales, Sydney, NSW
| | - Richard Sullivan
- South Eastern Sydney Local Health District, Sydney, NSW
- University of New South Wales, Sydney, NSW
| | - Pamela Konecny
- South Eastern Sydney Local Health District, Sydney, NSW
- University of New South Wales, Sydney, NSW
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24
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Negro E, Costedoat-Chalumeau N, Nivuori M, Gabiati C, Pallini G, Brucato A. Anakinra During Pregnancy in a Difficult to Treat Case of Recurrent Pericarditis. Can J Cardiol 2023; 39:1152-1153. [PMID: 36306922 DOI: 10.1016/j.cjca.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Enrica Negro
- Internal Medicine, Ospedale Fatebenefratelli, Milano, Italy.
| | - Nathalie Costedoat-Chalumeau
- Department of internal medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris University of Paris cité, Paris, France
| | | | | | - Giada Pallini
- Internal Medicine, Ospedale Fatebenefratelli, Milano, Italy
| | - Antonio Brucato
- Università di Milano, Ospedale Fatebenefratelli, Milano, Italy
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25
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Ntsekhe M. Pericardial Disease in the Developing World. Can J Cardiol 2023; 39:1059-1066. [PMID: 37201721 DOI: 10.1016/j.cjca.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/20/2023] Open
Abstract
Pericardial disease in the developing world is dominated primarily by effusive and constrictive syndromes and contributes to the acute and chronic heart failure burden in many regions. The confluence of geography (location in the tropics), a significant burden of diseases of poverty and neglect, and a significant contribution of communicable diseases to the general burden of disease is reflected in the wide etiological spectrum of causes of pericardial disease. The prevalence of Mycobacterium tuberculosis in particular, is high throughout much of the developing world where it is the most frequent and important cause of pericarditis and is associated with significant morbidity and mortality. Acute viral/idiopathic pericarditis, which is the primary manifestation of pericardial disease in the developed world is believed to occur significantly less frequently in the developing world. Although diagnostic approaches and criteria to establish the diagnosis of pericardial disease are similar throughout the globe, resource constraints such as access to multimodality imaging and hemodynamic assessment are a major limitation in much of the developing world. These important considerations significantly influence the diagnostic and treatment approaches, and outcomes related to pericardial disease.
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Affiliation(s)
- Mpiko Ntsekhe
- The Division of Cardiology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
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26
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Camilli M, Viscovo M, Hohaus S, Lamendola P, Verrecchia E, Gerardino L, Crea F, Lombardo A, Manna R. Incessant Pericarditis Successfully Treated With Anakinra in a Patient on Active Treatment for Mediastinal Lymphoma. Can J Cardiol 2023; 39:1154-1157. [PMID: 36334641 DOI: 10.1016/j.cjca.2022.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Massimiliano Camilli
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marcello Viscovo
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Rome, Italy
| | - Stefan Hohaus
- Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Rome, Italy; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Priscilla Lamendola
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elena Verrecchia
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Periodic Fevers Research Center, Catholic University of the Sacred Heart, Rome, Italy
| | - Laura Gerardino
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Periodic Fevers Research Center, Catholic University of the Sacred Heart, Rome, Italy
| | - Filippo Crea
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonella Lombardo
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Raffaele Manna
- Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Periodic Fevers Research Center, Catholic University of the Sacred Heart, Rome, Italy
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27
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Imazio M, Mardigyan V, Andreis A, Franchin L, De Biasio M, Collini V. New Developments in the Management of Recurrent Pericarditis. Can J Cardiol 2023; 39:1103-1110. [PMID: 37075863 DOI: 10.1016/j.cjca.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
Recurrent pericarditis is a common and troublesome complication that affects 15%-30% of patients with a previous episode of pericarditis. However, the pathogenesis of these recurrences is not well understood, and most cases remain idiopathic. Recent advances in medical therapy, including the use of colchicine and anti-interleukin-1 agents like anakinra and rilonacept, have suggested an autoinflammatory rather than an autoimmune mechanism for recurrences with an inflammatory phenotype. As a result, a more personalized approach to treatment is now recommended. Patients with an inflammatory phenotype (fever and elevated C-reactive protein level) should receive colchicine and anti-interleukin-1 agents as first-line therapy, whereas those without systemic inflammation should receive low to moderate doses of corticosteroids (eg, prednisone 0.2-0.5 mg/kg/d as an initial dose) and consider azathioprine and intravenous human immunoglobulins in the case of corticosteroid failure. Tapering of corticosteroids should be slow after achieving clinical remission. In this article, we review the new developments in the management of recurrent pericarditis.
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Affiliation(s)
- Massimo Imazio
- Cardiology and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, and Department of Medicine, University of Udine, Udine, Italy.
| | - Vartan Mardigyan
- Department of Medicine, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alessandro Andreis
- University Cardiology, Cardiovascular Department, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Luca Franchin
- Cardiology and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, and Department of Medicine, University of Udine, Udine, Italy
| | - Marzia De Biasio
- Cardiology and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, and Department of Medicine, University of Udine, Udine, Italy
| | - Valentino Collini
- Cardiology and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, and Department of Medicine, University of Udine, Udine, Italy
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Bitan R, Freund O, Zeltser D, Ebril S. Type A Aortic Dissection in a Young Patient Presenting with Pericarditis: A Case Report. Isr Med Assoc J 2023; 25:577-579. [PMID: 37574900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Affiliation(s)
- Roy Bitan
- Department of Emergency Medicine Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ophir Freund
- Department of Internal Medicine B, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Zeltser
- Department of Emergency Medicine Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sivan Ebril
- Department of Emergency Medicine Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Mardigyan V, Imazio M, Brucato A, Fedak PWM, Klein AL. Unveiling the Spectrum of Pericardial Diseases: Insights, Novelties, and Future Directions. Can J Cardiol 2023; 39:1044-1046. [PMID: 37343717 DOI: 10.1016/j.cjca.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023] Open
Affiliation(s)
- Vartan Mardigyan
- Department of Medicine, Jewish General Hospital, Montréal, Québec, Canada.
| | - Massimo Imazio
- Department of Medicine, University Hospital Santa Maria della Misericordia, and University of Udine, Italy; Department of Medicine, University Hospital Santa Maria della Misericordia, and University of Udine, Italy
| | - Antonio Brucato
- Department of Biomedical and Clinical Sciences, University of Milan, Fatebenefratelli Hospital, Milan, Italy
| | - Paul W M Fedak
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Allan L Klein
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Abstract
PURPOSE OF REVIEW Provide an update on current management and most recent evidence in the treatment of pediatric pericarditis. RECENT FINDINGS While treatment of acute pericarditis has not significantly changed over the last decade, management of recurrent acute pericarditis, with increased attention to autoinflammation as a causal mechanism, has evolved substantially. This includes clinical trial evidence that newer medications targeting interleukin-1 receptors are effective in recurrent forms of pericarditis. In addition, advanced imaging utilizing cardiac magnetic resonance has emerged as a particularly effective way to detect ongoing pericardial inflammation in support of more difficult-to-treat patients. SUMMARY Recent advances in acute and recurrent pericarditis management have allowed for a more tailored approach to the individual patient. Yet, unresolved questions require further research.
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Affiliation(s)
- Sravani Avula
- Division of Pediatric Cardiology, UT Southwestern, Children's Medical Center, Dallas, Texas, USA
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Gursu HA, Çetin İİ. Mid-cavitary hypertrophy after myocarditis in a patient with operated medulloblastoma. Cardiol Young 2023; 33:1220-1222. [PMID: 36523262 DOI: 10.1017/s1047951122003821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A 16-month-old girl was referred for tachycardia and upper respiratory tract infection. Echocardiographic examination revealed pericardial effusion, mild mitral regurgitation, and left ventricle systolic dysfunction. Patient was positive for Parainfluenza type 4 virus. Her laboratory tests revealed increased troponin I level. The patient was treated with intravenous immunoglobulin considering acute viral myopericarditis. Two weeks after treatment, midventricular hypertrophy was detected.
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Affiliation(s)
- Hazım Alper Gursu
- Pediatric Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
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Sayad R, Siddiq A, Hashim A, Elsaeidy AS. Can the current monkeypox affect the heart? A systematic review of case series and case report. BMC Cardiovasc Disord 2023; 23:328. [PMID: 37380955 PMCID: PMC10308700 DOI: 10.1186/s12872-023-03351-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Monkeypox is a zoonotic viral infection first reported in May 2022. Monkeypox cases present with prodromal symptoms, rash, and/or systemic complications. This study systematically reviews the monkeypox cases presented with any cardiac complications. METHODS A systematic literature search was done to locate papers that discuss any cardiac complications associated with monkeypox; then, data were analyzed qualitatively. RESULTS Nine articles, including the 13 cases that reported cardiac complications of the disease, were included in the review. Five cases previously had sex with men, and two cases had unprotected intercourse, which reveals the importance of the sexual route in disease transmission. All cases have a wide spectrum of cardiac complications, such as acute myocarditis, pericarditis, pericardial effusion, and myopericarditis. CONCLUSION This study clarifies the potential for cardiac complications in monkeypox cases and provides avenues for future research to determine the underlying mechanism. Also, we found that the cases with pericarditis were treated with colchicine, and those with myocarditis were treated with supportive care or cardioprotective treatment (Bisoprolol and Ramipril). Furthermore, Tecovirimat is used as an antiviral drug for 14 days.
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Affiliation(s)
- Reem Sayad
- Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Ahmed Hashim
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
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von Olshausen G, Tabrizi F, Sigurjónsdóttir R, Ringborn M, Höglund N, Hassel Jönsson A, Holmqvist F, Braunschweig F. Cardiac tamponades related to interventional electrophysiology procedures are associated with higher risk of short-term hospitalization for pericarditis but favourable long-term outcome. Europace 2023; 25:euad140. [PMID: 37306316 PMCID: PMC10259250 DOI: 10.1093/europace/euad140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023] Open
Abstract
AIMS To investigate the association of iatrogenic cardiac tamponades as a complication of invasive electrophysiology procedures (EPs) and mortality as well as serious cardiovascular events in a nationwide patient cohort during long-term follow-up. METHODS From the Swedish Catheter Ablation Registry between 2005 and 2019, a total of 58 770 invasive EPs in 44 497 patients were analysed. From this, all patients with periprocedural cardiac tamponades related to invasive EPs were identified (n = 200; tamponade group) and matched (1:2 ratio) to a control group (n = 400). Over a follow-up of 5 years, the composite primary endpoint-death from any cause, acute myocardial infarction, transitory ischaemic attack (TIA)/stroke, and hospitalization for heart failure-revealed no statistically significant association with cardiac tamponade [hazard ratio (HR) 1.22 (95% CI, 0.79-1.88)]. All single components of the primary endpoint as well as cardiovascular death revealed no statistically significant association with cardiac tamponade. Cardiac tamponade was associated with a significantly higher risk with hospitalization for pericarditis [HR 20.67 (95% CI, 6.32-67.60)]. CONCLUSION In this nationwide cohort of patients undergoing invasive EPs, iatrogenic cardiac tamponade was associated with an increased risk of hospitalization for pericarditis during the first months after the index procedure. In the long-term, however, cardiac tamponade revealed no significant association with mortality or other serious cardiovascular events.
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Affiliation(s)
- Gesa von Olshausen
- Department of Cardiology, Karolinska University Hospital, Solna, S1:02, SE-17176 Stockholm, Sweden
- Medical Department I (Cardiology, Angiology, Pneumology), Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, DE-81675 Munich, Germany
| | - Fariborz Tabrizi
- Department of Clinical Sciences, Karolinska Institute, Arrhythmia Center Stockholm, South Hospital, Sjukhusbacken 10, SE-11883, Stockholm, Sweden
| | - Rúna Sigurjónsdóttir
- Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Blåa Stråket 3, 141345 Göteborg, Sweden
| | - Michael Ringborn
- Thoracic Center, Blekinge County Hospital, Lasarettsvägen, SE-371 85, Karlskrona, Sweden
| | - Niklas Höglund
- Department of Public Health and Clinical Medicine, Umeå University, SE-90187 Umeå, Sweden
| | - Anders Hassel Jönsson
- Department of Cardiology, Linköping University Hospital, SE-581 85 Linköping, Sweden
| | - Fredrik Holmqvist
- Department of Cardiology, Skåne University Hospital Lund, SE-221 85 Lund, Sweden
| | - Frieder Braunschweig
- Department of Cardiology, Karolinska University Hospital, Solna, S1:02, SE-17176 Stockholm, Sweden
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Iqbal AM, Li KY, Gautam S. Colchicine usage for prevention of post atrial fibrillation ablation pericarditis in patients undergoing high-power short-duration ablation. J Cardiovasc Electrophysiol 2023; 34:1370-1376. [PMID: 37232420 DOI: 10.1111/jce.15941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Radiofrequency ablation (RFA) for atrial fibrillation (AF) has been associated with variable incidence (0.88%-10%) of pericarditis manifested as chest pain, possibly more prevalent with the advent of high-power short-duration (HPSD) ablation. This has led to the widespread use of colchicine in preventative protocols for postablation pericarditis. However, the efficacy of preventative colchicine has not been validated yet. OBJECTIVE To evaluate the efficacy of a routine postoperative colchicine regimen (0.6 mg twice a day for 14 days post-AF ablation) for prevention of postablation pericarditis in patients undergoing HPSD ablation. METHOD We retrospectively evaluated consecutive single-operator HPSD AF ablation procedures at our institution from June 2019 to July 2022. A colchicine protocol was introduced in June 2021 for the prevention of postablation pericarditis. All ablations were performed with 50 watts. Patients were divided into colchicine and noncolchicine groups. We recorded incidence of postablation chest pain, emergency room (ER) visit for chest pain, pericardial effusion, pericardiocentesis, any ER visit, hospitalization, AF recurrence, and cardioversion for AF within the first 30 days following ablation. We also recorded colchicine-related side effects and medication compliance. RESULTS Two hundred and ninety-four consecutive HPSD AF ablation patients were screened for the study. After implementing the prespecified exclusion criteria, a total of 205 patients were included in the final analysis, yielding 101 patients in the colchicine group and 104 patients in the noncolchicine group. Both groups were well-matched for demographic and procedural parameters. There was no significant difference in postablation chest pain (9.9% vs. 8.6%, p = .7), pericardial effusion (2.9% vs. 0.9%, p = .1), ER visits (11.9% vs. 12.5%, p = .2), 30-day hospitalization for AF recurrence (0.9% vs. 0.96%, p = .3), and 30-day need for cardioversion for AF (3.9% vs. 5.7%, p = .2). Fifteen (15) patients had severe colchicine-related diarrhea, out of which 12 discontinued it prematurely. There were no major procedural complications in either group. CONCLUSION In this single-operator retrospective analysis, prophylactic colchicine was not associated with significant reduction in the incidence of postablation chest pain, pericarditis, 30 day hospitalization, ER visits, or AF recurrence or need of cardioversion within first 30 days after HPSD ablation for AF. However, its usage was associated with significant diarrhea. This study concludes no additional advantage of prophylactic use of colchicine after HPSD AF ablation.
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Affiliation(s)
- Arshad Muhammad Iqbal
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Kai Yu Li
- Department of Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Sandeep Gautam
- Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, Missouri, USA
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Shahid R, Jin J, Hope K, Tunuguntla H, Amdani S. Pediatric Pericarditis: Update. Curr Cardiol Rep 2023; 25:157-170. [PMID: 36749541 PMCID: PMC9903287 DOI: 10.1007/s11886-023-01839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW While there have now been a variety of large reviews on adult pericarditis, this detailed review specifically focuses on the epidemiology, clinical presentation, diagnosis, and management of pediatric pericarditis. We have tried to highlight most pediatric studies conducted on this topic, with special inclusion of important adult studies that have shaped our understanding of and management for acute and recurrent pericarditis. RECENT FINDINGS We find that the etiology of pediatric pericarditis differs from adult patients with pericarditis and has evolved over the years. Also, with the current COVID-19 pandemic, it is important for pediatric clinicians to be aware of pericardial involvement both due to the infection and from vaccination. Oftentimes, pericarditis maybe the only cardiac involvement in children with COVID-19, and so caregivers should maintain a high index of suspicion when they encounter children with pericarditis. Large-scale contemporary epidemiological data regarding incidence and prevalence of both acute and recurrent pericarditis is lacking in pediatrics, and future studies should focus on highlighting this important research gap. Most of the current management strategies for pediatric pericarditis are from experiences gathered from adult data. Pediatric multicenter trials are warranted to understand the best management strategy for those with acute and recurrent pericarditis. CASE VIGNETTE A 6-year-old child with a past history of pericarditis almost 2 months ago comes in with a 2-day history of chest pain and fever. Per mother, he stopped his steroids about 2 weeks ago, and for the last 2 days has had a temperature of 102F and has been complaining of sharp mid-sternal chest pain that gets worse when he lies down and is relieved when he sits up and leans forward. On examination, he is tachycardic (heart rate 160 bpm), with normal blood pressure for age. He appears to be in pain (5/10), and on auscultation has a pericardial friction rub. His lab studies are notable for elevated white blood cell count and inflammatory markers (CRP and ESR). His electrocardiogram reveals sinus tachycardia and diffuse ST-elevation in all precordial leads. His echocardiogram demonstrates normal biventricular function and a trace pericardial effusion. His cardiac MRI confirms recurrent pericarditis. He is started on indomethacin and colchicine. He has complete resolution of his symptoms by day 3 of admission and is discharged with close follow-up.
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Affiliation(s)
- Rida Shahid
- grid.239578.20000 0001 0675 4725Department of Pediatric Cardiology, Cleveland Clinic Children’s Hospital, Cleveland, OH USA
| | - Justin Jin
- grid.413808.60000 0004 0388 2248Division of Pediatric Cardiology, Northwestern Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Kyle Hope
- grid.39382.330000 0001 2160 926XLillie Frank Abercrombie Division of Pediatric Cardiology, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX USA
| | - Hari Tunuguntla
- grid.39382.330000 0001 2160 926XLillie Frank Abercrombie Division of Pediatric Cardiology, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX USA
| | - Shahnawaz Amdani
- grid.239578.20000 0001 0675 4725Department of Pediatric Cardiology, Cleveland Clinic Children’s Hospital, Cleveland, OH USA
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Dini FL, Baldini U, Bytyçi I, Pugliese NR, Bajraktari G, Henein MY. Acute pericarditis as a major clinical manifestation of long COVID-19 syndrome. Int J Cardiol 2023; 374:129-134. [PMID: 36513284 PMCID: PMC9734068 DOI: 10.1016/j.ijcard.2022.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The long COVID-19 syndrome has been recently described and some reports have suggested that acute pericarditis represents important manifestation of long COVID-19 syndrome. The aim of this study was to identify the prevalence and clinical characteristics of patients with long COVID-19, presenting with acute pericarditis. METHODS We retrospectively included 180 patients (median age 47 years, 62% female) previously diagnosed with COVID-19, exhibiting persistence or new-onset symptoms ≥12 weeks from a negative naso-pharyngeal SARS CoV2 swamp test. The original diagnosis of COVID-19 infection was determined by a positive swab. All patients had undergone a thorough physical examination. Patients with suspected heart involvement were referred to a complete cardiovascular evaluation. Echocardiography was performed based on clinical need and diagnosis of acute pericarditis was achieved according to current guidelines. RESULTS Among the study population, shortness of breath/fatigue was reported in 52%, chest pain/discomfort in 34% and heart palpitations/arrhythmias in 37%. Diagnosis of acute pericarditis was made in 39 patients (22%). Mild-to-moderate pericardial effusion was reported in 12, while thickened and bright pericardial layers with small effusions (< 5 mm) with or without comet tails arising from the pericardium (pericardial B-lines) in 27. Heart palpitations/arrhythmias (OR:3.748, p = 0.0030), and autoimmune disease and allergic disorders (OR:4.147, p = 0.0073) were independently related to the diagnosis of acute pericarditis, with a borderline contribution of less likelihood of hospitalization during COVID-19 (OR: 0.100, p = 0.0512). CONCLUSION Our findings suggest a high prevalence of acute pericarditis in patients with long COVID-19 syndrome. Autoimmune and allergic disorders, and palpitations/arrhythmias were frequently associated with pericardial disease.
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Affiliation(s)
- Frank Lloyd Dini
- Centro Medico Sant'Agostino, Milano, Italy; University Clinical Centre of Kosova, Prishtina, Kosovo.
| | | | - Ibadete Bytyçi
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; University Clinical Centre of Kosova, Prishtina, Kosovo
| | | | - Gani Bajraktari
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; University Clinical Centre of Kosova, Prishtina, Kosovo
| | - Michael Y Henein
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Aziminia N, Soman B, Samoes J, Randhawa R, Ormerod JOM, Kardos A. A diagnostic conundrum of a "ring of fire": a case of tuberculous perimyocarditis. Lancet 2023; 401:470-471. [PMID: 36774156 DOI: 10.1016/s0140-6736(22)02470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 02/11/2023]
Affiliation(s)
- Nikoo Aziminia
- Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Biji Soman
- Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Jose Samoes
- Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Rabinder Randhawa
- Department of Respiratory Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Julian O M Ormerod
- Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Attila Kardos
- Department of Cardiology, Translational Cardiovascular Research Group, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK; Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham, UK.
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Affiliation(s)
- George Lazaros
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
| | - Costas Tsioufis
- 1st Cardiology Clinic, National and Kapodistrian University of Athens, School of Medicine, Hippokration General Hospital, Athens, Greece
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Kapačinskaitė M, Gabartaitė D, Šatrauskienė A, Sakaitė I, Maneikienė VV, Zorinas A, Janušauskas V. A Rare Case of Primary Purulent Pericarditis Caused by Streptococcus constellatus. Medicina (B Aires) 2023; 59:medicina59010159. [PMID: 36676783 PMCID: PMC9866074 DOI: 10.3390/medicina59010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
Background: Bacteria-caused acute pericarditis is a very rare entity. It is usually associated with an underlying infection or compromised immune system. Primary purulent pericarditis in a previously healthy individual is highly unexpected; therefore, it is likely to have a delayed diagnosis and poor outcomes. Case: We report a case of an adult immunocompetent patient with primary bacterial pericarditis caused by a member of the commensal oral flora Streptococcus constellatus. The patient presented with septic shock and cardiac tamponade, and was further complicated with constrictive pericarditis, which was successfully treated with pericardiectomy. Conclusions: Bacterial pericarditis is a fulminant disease with a high mortality and complication rate. Fast recognition and prompt therapy are required to achieve a full recovery.
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Affiliation(s)
- Medeinė Kapačinskaitė
- Faculty of Medicine, Vilnius University, M.K. Čiurlionio g. 21, 03101 Vilnius, Lithuania
- Correspondence:
| | - Dovilė Gabartaitė
- Department of Cardiology, Center of Cardiology and Angiology, Vilnius University Hospital Santaros Clinics, Santariškių g. 2, 08661 Vilnius, Lithuania
| | - Agnė Šatrauskienė
- Faculty of Medicine, Vilnius University, M.K. Čiurlionio g. 21, 03101 Vilnius, Lithuania
| | - Ieva Sakaitė
- Faculty of Medicine, Vilnius University, M.K. Čiurlionio g. 21, 03101 Vilnius, Lithuania
| | | | - Aleksejus Zorinas
- Faculty of Medicine, Vilnius University, M.K. Čiurlionio g. 21, 03101 Vilnius, Lithuania
| | - Vilius Janušauskas
- Faculty of Medicine, Vilnius University, M.K. Čiurlionio g. 21, 03101 Vilnius, Lithuania
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Collini V, Imazio M, De Biasio M, Sinagra G. Coronavirus disease 2019 vaccination-related pericarditis: a single tertiary-center experience. J Cardiovasc Med (Hagerstown) 2022; 23:779-783. [PMID: 36166325 PMCID: PMC9671544 DOI: 10.2459/jcm.0000000000001365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/25/2022] [Accepted: 08/08/2022] [Indexed: 11/05/2022]
Abstract
AIMS Vaccination represents a cornerstone of prevention in the COVID-19 pandemic. Rare adverse events including acute pericarditis and myopericarditis have been reported. METHODS All consecutive patients referred to our referral center for pericardial diseases following COVID-19 vaccination from 1 April 2021 to 15 April 2022 were included. Acute pericarditis and myopericarditis were diagnosed according to ESC guidelines. Patients with SARS-CoV-2 infection were excluded from the study. RESULTS Twenty-four patients (79% men) aged 39.7 ± 19.8 years were referred to our center with pericarditis after receiving COVID-19 vaccination. Thirteen (54%) patients were diagnosed with myopericarditis. The mean time between vaccination and symptoms onset was 7.0 ± 4.9 days, and the most frequent symptom was pericarditic chest pain (83%). Respectively, 50 and 33% of patients presented after the second and the third dose of the vaccine. Almost all patients were treated with both nonsteroidal anti-inflammatory drugs and colchicine. Five patients (21%) experienced a recurrence of pericarditis. No patient died or developed constrictive pericarditis. Mean follow-up was 8.0 ± 3.2 months. CONCLUSION COVID-19 vaccine-related pericarditis typically manifest with mild clinical signs, in young male individuals, a few days after the second or third vaccine dose and are commonly characterized by a rapid complete recovery.
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Affiliation(s)
- Valentino Collini
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste
- Cardiology, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Massimo Imazio
- Cardiology, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Marzia De Biasio
- Cardiology, Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Gianfranco Sinagra
- Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste
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Naveed Z, Li J, Wilton J, Spencer M, Naus M, Velásquez García HA, Kwong JC, Rose C, Otterstatter M, Janjua NZ. Comparative Risk of Myocarditis/Pericarditis Following Second Doses of BNT162b2 and mRNA-1273 Coronavirus Vaccines. J Am Coll Cardiol 2022; 80:1900-1908. [PMID: 36357091 PMCID: PMC9639791 DOI: 10.1016/j.jacc.2022.08.799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/25/2022] [Indexed: 11/09/2022]
Abstract
Background Postmarketing evaluations have linked myocarditis to COVID-19 mRNA vaccines. However, few population-based analyses have directly compared the safety of the 2 mRNA COVID-19 vaccines. Objectives This study aimed to compare the risk of myocarditis, pericarditis, and myopericarditis between BNT162b2 and mRNA-1273. Methods We used data from the British Columbia COVID-19 Cohort (BCC19C), a population-based cohort study. The exposure was the second dose of an mRNA vaccine. The outcome was diagnosis of myocarditis, pericarditis, or myopericarditis during a hospitalization or an emergency department visit within 21 days of the second vaccination dose. We performed multivariable logistic regression to assess the association between vaccine product and the outcomes of interest. Results The rates of myocarditis and pericarditis per million second doses were higher for mRNA-1273 (n = 31, rate 35.6; 95% CI: 24.1-50.5; and n = 20, rate 22.9; 95% CI: 14.0-35.4, respectively) than BNT162b2 (n = 28, rate 12.6; 95% CI: 8.4-18.2 and n = 21, rate 9.4; 95% CI: 5.8-14.4, respectively). mRNA-1273 vs BNT162b2 had significantly higher odds of myocarditis (adjusted OR [aOR]: 2.78; 95% CI: 1.67-4.62), pericarditis (aOR: 2.42; 95% CI: 1.31-4.46) and myopericarditis (aOR: 2.63; 95% CI: 1.76-3.93). The association between mRNA-1273 and myocarditis was stronger for men (aOR: 3.21; 95% CI: 1.77-5.83) and younger age group (18-39 years; aOR: 5.09; 95% CI: 2.68-9.66). Conclusions Myocarditis/pericarditis following mRNA COVID-19 vaccines is rare, but we observed a 2- to 3-fold higher odds among individuals who received mRNA-1273 vs BNT162b2. The rate of myocarditis following mRNA-1273 receipt is highest among younger men (age 18-39 years) and does not seem to be present at older ages. Our findings may have policy implications regarding the choice of vaccine offered.
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Affiliation(s)
- Zaeema Naveed
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Julia Li
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - James Wilton
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Michelle Spencer
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Monika Naus
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Héctor A Velásquez García
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey C Kwong
- Public Health Ontario, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada
| | - Caren Rose
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Otterstatter
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Naveed Z Janjua
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Outcomes and Evaluation, St Paul's Hospital, Vancouver, British Columbia, Canada
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Higashioka K, Migita R, Ota T, Uchino A, Niiro H. Successful Treatment of Systemic Sclerosis-related Pericarditis with Mycophenolate Mofetil and Low-dose Prednisolone. Intern Med 2022; 61:3125-3130. [PMID: 35283383 PMCID: PMC9646350 DOI: 10.2169/internalmedicine.8844-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We herein report a case of systemic sclerosis (SSc)-related pericarditis successfully treated with mycophenolate mofetil (MMF) and low-dose prednisolone (PSL). The patient was a 72-year-old woman with anti-centromere antibody. Her clinical manifestations were Raynaud phenomenon, bilateral pleural effusion, pericardial effusion and skin tightness. Based on the findings of exudative pericardial effusion with the absence of pulmonary arterial hypertension from the results of the cardiac catheter and pericardiocentesis, she was diagnosed with SSc-related pericarditis and treated with PSL10 mg and MMF 1 g per day, leading to the complete resolution of pericarditis. These findings suggested that MMF and low-dose PSL were effective for SSc-related pericarditis.
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Affiliation(s)
| | - Rioko Migita
- Department of Rheumatology, Aso Iizuka Hospital, Japan
| | - Toshiyuki Ota
- Department of Rheumatology, Aso Iizuka Hospital, Japan
| | - Ayumi Uchino
- Department of Rheumatology, Aso Iizuka Hospital, Japan
| | - Hiroaki Niiro
- Department of Medical Education, Kyushu University Graduate School of Medical Sciences, Japan
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Abstract
Myopericarditis is a condition, which primarily involves the pericardium, with minimal myocardial involvement. In myopericarditis, chest pain, elevated cardiac enzymes, and electrocardiographic changes occur. Although COVID-19 mRNA vaccines significantly contribute to preventing the COVID-19 disease, rarely myocarditis and/or pericarditis may develop due to these vaccines. We present a previously healthy 14-year-old male patient who developed myopericarditis after receiving the second dose of the COVID-19 mRNA vaccine.
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Affiliation(s)
- Mehmet Türe
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Alper Akın
- Department of Pediatric Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Muhammed Demir
- Department of Cardiology, Dicle University Hospital, Diyarbakır, Turkey
| | - Cihan Akay
- Department of Pediatric, Dicle University Hospital, Diyarbakır, Turkey
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45
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Kim HY, Cho JY, Yoon HJ, Choi YD, Ahn Y, Jeong MH, Cho JG, Kim KH. A Case Report for Acute Myopericarditis After NVX-CoV2373 (Novavax ®) COVID-19 Vaccination. J Korean Med Sci 2022; 37:e265. [PMID: 36038960 PMCID: PMC9424696 DOI: 10.3346/jkms.2022.37.e265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/25/2022] [Indexed: 11/20/2022] Open
Abstract
Post-vaccination myocarditis after administration of the NVX-CoV2373 coronavirus disease 2019 (COVID-19) vaccine has been reported in a limited population. We report the first biopsy-proven case of myopericarditis after administration of second dose of NVX-CoV2373 COVID-19 vaccine (Novavax®) in Korea. A 30-year-old man was referred to emergency department with complaints of chest pain and mild febrile sense for two days. He received the second dose vaccine 17 days ago. Acute myopericarditis by the vaccination was diagnosed by cardiac endomyocardial biopsy. He was treated with corticosteroid 1 mg/kg/day for 5 days and tapered for one week. He successfully recovered and was discharged on the 12th day of hospitalization. The present case suggests acute myopericarditis as a vaccination complication by Novavax® in Korea.
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Affiliation(s)
- Hyung Yoon Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Jae Yeong Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Hyun Ju Yoon
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Yoo-Duk Choi
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
| | - Kye Hun Kim
- Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea.
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Papaefthymiou A, Kyriakos N, Giakoumis M, Doulberis M, Mylonas I, Kountouras J, Liatsos C. ACUTE MYOPERICARDITIS IN A PATIENT WITH ULCERATIVE COLITIS AND THE ROLE OF MESALAMINE: A CASE REPORT. Gastroenterol Nurs 2022; 45:276-277. [PMID: 35283437 DOI: 10.1097/sga.0000000000000617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/30/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Apostolis Papaefthymiou
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
| | - Nikolaos Kyriakos
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
| | - Marios Giakoumis
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
| | - Michael Doulberis
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
| | - Iordanis Mylonas
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
| | - Jannis Kountouras
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
| | - Christos Liatsos
- Apostolis Papaefthymiou, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece; Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Nikolaos Kyriakos, PhD, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Marios Giakoumis, MD, is Consultant Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Michael Doulberis, PhD, MD, DVM, is Resident Gastroenterologist, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece; Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland
- Iordanis Mylonas, MD, is Resident Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
- Jannis Kountouras, PhD, MD, is Professor of Medicine, Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Christos Liatsos, PhD, MD, is Director Gastroenterologist, Department of Gastroenterology, 401 General Military Hospital of Athens, Athens, Greece
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Boscutti A, Cereda G, Lazzaretti M, Enrico P, Fiorentini A, Prunas C, Callari A, Fontana E, Delvecchio G, Brambilla P. Successful clozapine rechallenge after myopericarditis: a case report. Int Clin Psychopharmacol 2022; 37:179-181. [PMID: 35661661 PMCID: PMC10885862 DOI: 10.1097/yic.0000000000000407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Clozapine-induced myocarditis and pericarditis are uncommon adverse effects of clozapine treatment. However, in most cases, they lead to clozapine discontinuation. Here, we describe a case of successful clozapine rechallenge after clozapine-induced myopericarditis. The patient, a 31-year-old male with treatment-resistant schizophrenia (TRS), developed dyspnea on exertion and chest pain on day 19 after the start of clozapine titration. An electrocardiogram (ECG) showed widespread, mild, convex ST interval elevation. While troponin levels were mildly elevated, the echocardiogram was unremarkable. A myopericarditis diagnosis was formulated, and clozapine was stopped, with a progressive resolution of clinical, laboratory and ECG abnormalities. After 6 months, a rechallenge with clozapine was attempted. A very slow titration scheme was adopted, along with close monitoring of clinical, laboratory and ECG parameters. Clozapine target dose was reached without the occurrence of any abnormality. Given the unique role of clozapine in the management of TRS, clozapine rechallenge may be considered after pericarditis, even with troponin levels elevation. Further studies are needed to update current clinical guidelines.
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Affiliation(s)
- Andrea Boscutti
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Guido Cereda
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Alessio Fiorentini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Callari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Fontana
- Department of Pathophysiology and Transplantation, University of Milan and
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan and
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Wong HL, Hu M, Zhou CK, Lloyd PC, Amend KL, Beachler DC, Secora A, McMahill-Walraven CN, Lu Y, Wu Y, Ogilvie RP, Reich C, Djibo DA, Wan Z, Seeger JD, Akhtar S, Jiao Y, Chillarige Y, Do R, Hornberger J, Obidi J, Forshee R, Shoaibi A, Anderson SA. Risk of myocarditis and pericarditis after the COVID-19 mRNA vaccination in the USA: a cohort study in claims databases. Lancet 2022; 399:2191-2199. [PMID: 35691322 PMCID: PMC9183215 DOI: 10.1016/s0140-6736(22)00791-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several passive surveillance systems reported increased risks of myocarditis or pericarditis, or both, after COVID-19 mRNA vaccination, especially in young men. We used active surveillance from large health-care databases to quantify and enable the direct comparison of the risk of myocarditis or pericarditis, or both, after mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech) vaccinations. METHODS We conducted a retrospective cohort study, examining the primary outcome of myocarditis or pericarditis, or both, identified using the International Classification of Diseases diagnosis codes, occurring 1-7 days post-vaccination, evaluated in COVID-19 mRNA vaccinees aged 18-64 years using health plan claims databases in the USA. Observed (O) incidence rates were compared with expected (E) incidence rates estimated from historical cohorts by each database. We used multivariate Poisson regression to estimate the adjusted incidence rates, specific to each brand of vaccine, and incidence rate ratios (IRRs) comparing mRNA-1273 and BNT162b2. We used meta-analyses to pool the adjusted incidence rates and IRRs across databases. FINDINGS A total of 411 myocarditis or pericarditis, or both, events were observed among 15 148 369 people aged 18-64 years who received 16 912 716 doses of BNT162b2 and 10 631 554 doses of mRNA-1273. Among men aged 18-25 years, the pooled incidence rate was highest after the second dose, at 1·71 (95% CI 1·31 to 2·23) per 100 000 person-days for BNT162b2 and 2·17 (1·55 to 3·04) per 100 000 person-days for mRNA-1273. The pooled IRR in the head-to-head comparison of the two mRNA vaccines was 1·43 (95% CI 0·88 to 2·34), with an excess risk of 27·80 per million doses (-21·88 to 77·48) in mRNA-1273 recipients compared with BNT162b2. INTERPRETATION An increased risk of myocarditis or pericarditis was observed after COVID-19 mRNA vaccination and was highest in men aged 18-25 years after a second dose of the vaccine. However, the incidence was rare. These results do not indicate a statistically significant risk difference between mRNA-1273 and BNT162b2, but it should not be ruled out that a difference might exist. Our study results, along with the benefit-risk profile, continue to support vaccination using either of the two mRNA vaccines. FUNDING US Food and Drug Administration.
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Affiliation(s)
- Hui-Lee Wong
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Mao Hu
- Acumen, Burlingame, CA, USA
| | - Cindy Ke Zhou
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Patricia C Lloyd
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | | | | | - Yun Lu
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Yue Wu
- Acumen, Burlingame, CA, USA
| | | | | | | | | | | | | | | | | | | | | | - Joyce Obidi
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Richard Forshee
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Azadeh Shoaibi
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Steven A Anderson
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.
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Marques da Silva B, Oliveira J, Pereira M, Lopes JA, Pinto Abreu C. Acute pericarditis after COVID 19 in a peritoneal dialysis patient. CEN Case Rep 2022; 11:487-489. [PMID: 35507290 PMCID: PMC9067338 DOI: 10.1007/s13730-022-00705-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/12/2022] [Indexed: 12/15/2022] Open
Abstract
COVID-19 is known to affect numerous organs which have ACE-2 receptors, lung being the most involved organ. Nevertheless, cardiac involvement is not uncommon and can occur through a variety of manifestations. The authors hereby report a case of pericarditis following SARS-CoV-2 infection. A 54-year-old man with end stage kidney disease under peritoneal dialysis presented with acute chest pain approximately 1 month after being diagnosed with COVID-19. Electrocardiogram revealed widespread ST segment elevation. The diagnosis of acute pericarditis secondary to the viral infection was made and the patient was treated accordingly. Etiology of acute pericarditis can be very varied, and, in many times, no cause is ascertained. In such circumstances, viral or immune mediated etiologies are assumed. In our case, since no cause was proven, pericarditis was assumed as secondary to the SARS-CoV-2 infection. This entity is probably underdiagnosed. In patients undergoing dialysis, uremic pericarditis is commonly the etiology. However, different causes must be taken into consideration, COVID-19 being one of them.
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Affiliation(s)
- Bernardo Marques da Silva
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Universitário de Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal.
| | - João Oliveira
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Universitário de Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - Marta Pereira
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Universitário de Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - José António Lopes
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Universitário de Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal
| | - Cristina Pinto Abreu
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Universitário de Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal
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Tai SS, Siek SS, Siti Hajar MF, Azri AM, Chin HH, Chin PW. Acute pericarditis as a clinical manifestation in COVID-19 infection in a district hospital setting. Med J Malaysia 2022; 77:393-395. [PMID: 35638498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The global outbreak of coronavirus disease 2019(COVID-19) pandemic has heavily impacted the health service, leading to increased mortality and morbidity. Although known to manifest primarily as a respiratory illness, there are reports of cardiac involvement as extrapulmonary manifestation. We are reporting a case of pericarditis in a young patient who presented with only cardiac symptoms in COVID-19. He was admitted to the hospital for observation and treated with oral colchicine and oral ibuprofen. His conditions improved and subsequently discharged well. Acute pericarditis can present as part of the COVID-19 extrapulmonary spectrum. Therefore, it is important and challenging for clinicians to recognise the atypical presentations of COVID-19 to reduce morbidity and mortality.
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Affiliation(s)
- S S Tai
- Hospital Enche Besar Hajjah Khalsom, Malaysia.
| | - S S Siek
- Hospital Enche Besar Hajjah Khalsom, Malaysia
| | | | - A M Azri
- Hospital Enche Besar Hajjah Khalsom, Malaysia
| | - H H Chin
- Hospital Enche Besar Hajjah Khalsom, Malaysia
| | - P W Chin
- Hospital Enche Besar Hajjah Khalsom, Malaysia
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