Chronic constrictive pericarditis following uremic hemopericardium

Lindsay, Joseph; Crawley, I.Sylvia; Callaway, George M.

doi:10.1016/0002-8703(70)90426-6

Cited by 34 publications

(13 citation statements)

References 8 publications

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“…A study on hemodynamic parameters in uremic patients demonstrated an increase in arterial pressure, cardiac output, plasma volume and total peripheral resistance, and a lower creatinine clearance in those with signs of circulatory congestion . Although left ventricular failure is more common in early pericarditis, right ventricular insufficiency is predominant in late pericarditis . Cardiac index can be high or remain normal.…”

Section: The Pericardiummentioning

confidence: 99%

“…Moreover, persistent signs of volume overload, absence of arterial hypertension, pericarditis or pericardial effusion, decreased myocardial contractility, ejection fraction, and increased end‐diastolic pressures are indicative of uremic cardiomyopathy …”

Section: The Pericardiummentioning

confidence: 99%

“…Uremic patients are at a greater risk of bleeding and coagulopathy due to platelet dysfunction, an altered coagulation cascade, and activation of the fibrinolytic system, in addition to an inflamed pericardium. Repeated bouts of hemopericardium leads to the development of scar tissue and subsequently constrictive pericarditis …”

Section: The Pericardiummentioning

confidence: 99%

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Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

Rehman

Kumar

et al. 2017

Clinical Cardiology

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A rising prevalence of end-stage renal disease (ESRD) has led to a rise in ESRD-related pericardial syndromes, calling for a better understanding of its pathophysiology, diagnoses, and management. Uremic pericarditis, the most common manifestation of uremic pericardial disease, is a contemporary problem that calls for intensive hemodialysis, anti-inflammatories, and often, drainage of large inflammatory pericardial effusions. Likewise, asymptomatic pericardial effusions can become large and impact the hemodynamics of patients on chronic hemodialysis.Constrictive pericarditis is also well documented in this population, ultimately resulting in pericardiectomy for definitive treatment. The management of pericardial diseases in ESRD patients involves internists, cardiologists, and nephrologists. Current guidelines lack clarity with respect to the management of pericardial processes in the ESRD population. Our review aims to describe the etiology, classification, clinical manifestations, diagnostic imaging tools, and treatment options of pericardial diseases in this population.

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Section: The Pericardiummentioning

confidence: 99%

Section: The Pericardiummentioning

confidence: 99%

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Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

Rehman

Kumar

et al. 2017

Clinical Cardiology

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show abstract

“…For persistent or recurrent effusion, especially with any hemodynamic instability, placement of a pericardial window for permanent drainage should be performed, especially because repeated percutaneous pericardiocenteses may lead to hemorrhage from the friable pericardium. Constrictive physiology will develop in about 10% of patients with repeated bouts of pericarditis, necessitating total pericardiectomy [61 ].…”

Section: Diagnostic Testsmentioning

confidence: 99%

Pericardial Disease in the Intensive Care Setting

Thomas

LeWinter

1987

J Intensive Care Med

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Pericardial disease commonly occurs in the intensive care setting, but its timely diagnosis may be missed. The normal pericardium serves as a lubricated sac within which the heart may beat with minimal friction. The effect of the pericardium on cardiac filling at normal diastolic pressures is not clear; however, it may limit cardiac dilation in states of acute volume overload such as mitral regurgitation and right ventricular infarction. Pericardial disease may be divided into two catego ries : those cases that result from inflammation of the pericardium (pericarditis), and those cases in which a pericardial effusion or the thickened pericardium itself causes hemodynamic changes (tamponade and constric tion). Simple pericarditis should not lead to any hemo dynamic alteration other than tachycardia. In both tam ponade and constriction, the jugular venous pressure is elevated with low forward cardiac output; tamponade typically shows pulsus paradoxus, whereas constric tion more frequently shows Kussmaul's sign. The electrocardiogram may show diffuse ST segment elevation with PR segment depression in pericarditis; a large pericardial effusion, even with early tamponade, may not by itself cause any changes in the electrocar diogram. The echocardiogram is invaluable in diagnos ing the presence of a pericardial effusion and recogniz ing tamponade physiology (diastolic collapse of the right ventricular outflow tract and invagination of the right atrium). In selected patients, simple pericarditis may be managed outside of the hospital. Anyone suspected of having a hemodynamically significant pericardial effu sion should be hospitalized, usually in an intensive care unit. Pericardiocentesis should be performed under op timal monitoring conditions, although in an emergency, blind pericardiocentesis may be attempted. Recognition of the cause of the pericardial process will guide its treatment. Management of selected pericardial syn dromes is discussed later in this review.

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“…Only five of these patients had fever before diagnosis, but a further four patients developed fever on the day of diagnosis or some days later. [12][13][14][15][16][17] No fever *Developed fever on or after day of diagnosis.…”

Section: Possible Aetiological Factors In Uraemic Pericarditismentioning

confidence: 99%

Management of uraemic pericarditis.

Krämer¹,

Wigger²,

Scheler³

1975

BMJ

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564BRITISH MEDICAL JOURNAL 6 DECEMBER 1975 biotics. Polk and Lopez-Mayer25 gave cephaloridine alone in the same way, and their practice was followed by Evans and Pollock.2' Campbell28 relied on large doses of penicillin alone, and Stokes et all 9 reported encouraging preliminary results from two doses of a combination of lincomycin with either gentamicin or tobramycin. This form of prophylaxis is logical, innocuous, since side effects are unlikely from so few doses, and evidently effective. And it has wide applications: the more specialised uses of antibiotics in surgery, notably the prevention of infection in burns, cannot be discussed here. Among other applications in surgery are the prevention of urinary tract infections, referred to above, and the local application of antibiotics in wounds. This is another relatively innocuous use which is to be recommended in so far as it is proved effective. This type of use and the systemic administration of only a few doses are much to be preferred

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Chronic constrictive pericarditis following uremic hemopericardium

Cited by 34 publications

References 8 publications

Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end‐stage renal disease: Insights and pathophysiology

Pericardial Disease in the Intensive Care Setting

Management of uraemic pericarditis.

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