fibrin and Pericarditis

We describe an adult patient who presented with purulent pericarditis (PP) in whom two-dimensional transthoracic echocardiography demonstrated a marked decrease in the area of the right ventricular (RV) wall together with the overlying fibrin following intrapericardial administration of a fibrinolytic agent. Documentation of this decrease by measurements performed and illustrated on two-dimensional images has not been reported previously in an adult patient with PP, to the best of our knowledge.

Topics: Adult; Echocardiography; Fibrin; Fibrinolytic Agents; Humans; Pericarditis; Pericarditis, Constrictive; Thrombolytic Therapy

A three-year-old spayed domestic short-haired cat presented for evaluation of weight loss, cardiomegaly and pleural effusion. Echocardiographic examination demonstrated a thickened pericardium with mild pericardial effusion and a large volume of pleural effusion characterized by exudate. Although the cat was treated with antibiotics, the clinical symptoms did not improve. The cat developed dyspnea and died on day 7. Necropsy revealed a large amount of modified transudates ascites, pleural effusion and markedly dilated pericardium. Histopathological examination revealed severe exudation of fibrin and granulation tissue in a thick layer of the epicardium. The cat was diagnosed with fibrinous pericarditis secondary to bacterial infection.

Topics: Animals; Cat Diseases; Cats; Echocardiography; Female; Fibrin; Moraxella; Moraxellaceae Infections; Pericarditis; Radiography

Topics: Acute Disease; Echo-Planar Imaging; Female; Fibrin; Humans; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Middle Aged; Pericarditis; Pericardium

From a registry of 136 patients undergoing pericardiocentesis, 14 patients with autoimmune and 15 patients with neoplastic effusions were selected. All underwent pericardioscopy, epicardial and pericardial biopsy with histologic, immunohistologic, and polymerase chain reaction/or in situ hybridization analysis for microbial DNAs and RNA. Pericardioscopy identified neoplastic effusions by the high occurrence of protrusions. Fibrin threads and layers and neovascularization were found in both groups. For identification of the inflammatory and neoplastic process, the combined analysis of the cytology of the effusion and epicardial biopsy evaluation proved to be most important. Epicardial biopsy demonstrated a slightly higher sensitivity for identifying neoplastic disorders in the pericardium than cytology alone. Pericardial biopsy was inconclusive. Intrapericardial administration of 1 g of crystalloid triamcinolone in autoreactive pericarditis prevented recurrence in 13 of the 14 cases after 3 months and in 12 of the 14 cases after 1 year. In neoplastic effusion, intrapericardial administration of 50 mg cis-platin for 24 h prevented recurrence of a hemodynamically relevant effusion after 3 months in all, and after 6-12 months in 14 of 15 patients. Mortality in neoplastic effusion due to noncardiac tumor progression was 47 and 80%, respectively, after 3 and 6 months, as can be expected in endstage neoplastic disease. This pilot study demonstrates that local drug application is feasible, life-saving, and well tolerated by the patients. It opens perspectives for local drug application in other cardiac disorders as well.

Topics: Adolescent; Adult; Aged; Anti-Inflammatory Agents; Antineoplastic Agents; Autoimmune Diseases; Bacterial Infections; Biopsy; Cisplatin; Endoscopy; Female; Fibrin; Glucocorticoids; Humans; Male; Middle Aged; Neoplasms; Neovascularization, Pathologic; Paracentesis; Pericardial Effusion; Pericarditis; Pericardium; Pilot Projects; Sensitivity and Specificity; Survival Rate; Triamcinolone

A case of infective endocarditis which was complicated with hemorrhagic fibrinous pericarditis was reported. The hemorrhagic fibrinous pericarditis is a rare complication of infective endocarditis of the aortic root and is observed massive hemorrhage into the pericardial space. These patients should be considered for the aortic valve replacement early in the course of the disease.

Topics: Aortic Valve; Aortic Valve Insufficiency; Endocarditis, Bacterial; Fibrin; Heart Valve Prosthesis; Hemorrhage; Humans; Male; Middle Aged; Pericarditis

The autopsy data at the University of Southern California Liver Unit was studied during a 6-year period to investigate the relationship of fibrinous pericarditis with liver diseases. We found 18 cases of fibrinous pericarditis in 220 patients with alcoholic liver disease but none in 32 patients with fulminant and subacute hepatitis without alcoholism or in 39 patients with nonalcoholic cirrhosis. Although all the 18 patients with pericarditis had azotemia, 3 patients had pericarditis develop only in mild renal function impairment. These findings suggest that chronic alcoholism may precipitate pericarditis during the hepatorenal syndrome.

Topics: Adult; Aged; Aged, 80 and over; Fibrin; Hepatitis, Alcoholic; Humans; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pericarditis; Retrospective Studies; Uremia

During a period of 18 months, between July 1978 and January 1980, 4 adult horses were referred to the New York State College of Veterinary Medicine with evidence of congestive heart failure. Characteristic clinical abnormalities included marked muffling of heart sounds, tachycardia, jugular vein distention, and peripheral edema. Treatment with antibiotics, diuretics, and anti-inflammatory drugs was unsuccessful, and all four died or were euthanatized and necropsied. At necropsy, there was marked distention of the pericardial sac with fluid, and thick layers of fibrin were deposited uniformly over the epicardium. In 3 cases, attempts to isolate bacteria and viruses from pericardial fluid were unsuccessful; in the 4th case, Actinobacillus equuli was isolated on culture of the pericardial fluid.

Topics: Actinobacillus; Animals; Electrocardiography; Female; Fibrin; Heart Failure; Horse Diseases; Horses; Lung; Pericarditis; Radiography

Topics: Adolescent; Afibrinogenemia; Blood Coagulation Disorders; Bone Marrow Cells; Cardiac Tamponade; Factor V Deficiency; Factor VIII; Fibrin; Hemorrhagic Disorders; Humans; Leukemia, Myeloid, Acute; Male; Pericarditis; Pericardium; Staining and Labeling