Cardiac tamponade as a manifestation of severe dermatomyositis

Abstract

In connective tissue disorders, the incidence of pericardial disease and pericardial effusion can be up to 58%, and if untreated, it can lead to cardiac tamponade which can be fatal. Physicians must have a high index of suspicion for this disease as diagnosis can be delayed while evaluating more common causes of tachycardia and hypotension in the immunosuppressed (ie, sepsis). We present a 55-year-old woman with a severe case of dermatomyositis, marked by significant weight loss, a bedridden state and hallmark cutaneous findings. On evaluation of interstitial lung disease, a pericardial effusion was incidentally noted. Serial examination revealed increasing fluid accumulation and progressive tachycardia, and diagnosis of cardiac tamponade was made on echocardiography. After initial pericardiocentesis, the effusion rapidly re-accumulated requiring a pericardial window. In severe presentations of rheumatic disease, cardiac tamponade should be considered as a cause of tachycardia, with or without associated hypotension.

Concurrent myopathy and inflammatory cardiac disease in COVID-19 patients: a case series and literature review

“…COVID19 related myopathy and cardiac complications are known to have a strong inflammatory component [10,23,24]. Concomitant involvement can also occur in inflammatory myopathies or as a side effect of drugs such as checkpoint inhibitors which further highlight the possible inflammatory (as opposed to infectious) mechanism for this association [25,26]. In our case series considered together with cases from the literature review and other, most patients did not have a major respiratory complication and only two had critical COVID-19 pneumonia [4,22].…”

Miopatía inflamatoria autoinmune con taponamiento cardíaco. Reporte de caso

“…Sobre la medición enzimática es importante mencionar que la isoforma cardíaca troponina-I es el biomarcador más específico de compromiso miocárdico, mientras que la isoforma T de troponina y CK-MB pueden expresarse también en las fibras en regeneración del músculo esquelético (que suelen observarse en MII) 10 . La afección pericárdica es común en las enfermedades del tejido conectivo (lupus eritematoso sistémico, esclerosis sistémica, enfermedad mixta del tejido conectivo), en MII suele ser asintomática y menos frecuente (10% a 11.4%) 11 , las complicaciones como la pericarditis constrictiva o el taponamiento cardíaco secundario a una MII son infrecuentes [12][13][14][15] .…”