Journal article
Cardiac tamponade due to low-volume effusive constrictive pericarditis in a patient with uncontrolled type II autoimmune polyglandular syndrome
Acute cardiac care, Vol.16(1), pp.23-27
03/01/2014
DOI: 10.3109/17482941.2013.869344
PMID: 24552226
Abstract
Type II autoimmune polyglandular syndrome (APS), a relatively common endocrine disorder, includes primary adrenal insufficiency coupled with type 1 diabetes mellitus and/or autoimmune primary hypothyroidism. Autoimmune serositis, an associated disease, may present as symptomatic pericardial effusion. We present a case of a 54-year old male with APS who developed pericarditis leading to cardiac tamponade with a subacute loculated effusion. After urgent pericardiocentesis intrapericardial pressure dropped to 0, while central venous pressures remain elevated, consistent with acute effusive constrictive pericarditis. Contrast computerized tomography confirmed increased pericardial contrast enhancement. The patient recovered after prolonged inotropic support and glucocorticoid administration. He re-accumulated the effusion 16 days later, requiring repeat pericardiocentesis. Effusive-constrictive pericarditis, an uncommon pericardial syndrome, is characterized by simultaneous pericardial inflammation and tamponade. Prior cases of APS associated with cardiac tamponade despite low volumes of effusion have been reported, albeit without good demonstration of hemodynamic findings. We report a case of APS with recurrent pericardial effusion due to pericarditis and marked hypotension with comprehensive clinical and hemodynamic assessment. These patients may require aggressive support with pericardiocentesis, inotropes, and hormone replacement therapy. They should be followed closely for recurrent tamponade.
Details
- Title: Subtitle
- Cardiac tamponade due to low-volume effusive constrictive pericarditis in a patient with uncontrolled type II autoimmune polyglandular syndrome
- Creators
- William C Palmer - Department of Gastroenterology and Hepatology, Mayo ClinicAndrew Kurklinsky - Division of Cardiovascular Disease, Mayo ClinicGary Lane - Division of Cardiovascular Disease, Mayo ClinicKamonpun Ussavarungsi - Division of Pulmonary and Critical Care, Mayo ClinicJoseph L Blackshear - Division of Cardiovascular Disease, Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Acute cardiac care, Vol.16(1), pp.23-27
- Publisher
- Taylor & Francis
- DOI
- 10.3109/17482941.2013.869344
- PMID
- 24552226
- ISSN
- 1748-2941
- eISSN
- 1748-295X
- Language
- English
- Date published
- 03/01/2014
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094388802771
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