Pericardium
Mary N. Sheppard in Practical Cardiovascular Pathology, 2022
Recently, checkpoint inhibitors, such as ipilimumab and nivolumab, have emerged as an increasingly recognized cause of cardiac toxicity, including myocarditis and pericarditis. The two most prominent classes are monoclonal antibodies to cytotoxic-T-lymphocyte-associated antigen 4 (CTLA-4), and programmed cell death 1 (PD-1) and its ligand PD-L1, which have had numerous progressive applications in the field of oncology, and are expected to be implicated in more cases as their clinical use increases. Myopericarditis is a condition where there is inflammation involving both the pericardium and the myocardium. Myopericarditis can occur acutely after anthracycline administration. High-dose cyclophosphamide can cause acute cardiotoxicity manifesting as haemorrhagic myopericarditis. Death has also been reported in this context associated with pericardial effusions and tamponade. Pre-existing cardiac dysfunction, older age, use of other chemotherapeutic agents and type of cancer (e.g. lymphoma) are all risk factors. Renal impairment can increase the risk of cyclophosphamide-related acute myopericarditis. Acute myopericarditis has also been reported in the setting of ATRA (all trans retinoic acid) use for the treatment of acute promyelocytic leukaemia.
Acute coronary syndrome with haemodynamic instability
K Sarat Chandra, AJ Swamy in Acute Coronary Syndromes, 2020
Cardiovascular diseases in which the primary problem is not acute MI are: Stress-induced cardiomyopathy (Takotsubo cardiomyopathy) with characteristic finding of apical ballooning as seen on left ventriculography accompanied with ST-elevation on ECG and may present with CS in 20% patients [23].Hypertrophic cardiomyopathy or acute myopericarditis. These may present with any combination of chest pain, ST or T wave changes on ECG and hypotension.Pulmonary embolism.Acute MI due to ascending aortic dissection. Shock in this setting can result from the infarction caused by occlusion of one or more coronary arteries, acute aortic insufficiency and/or cardiac tamponade.
Development of palliative medicine in the United Kingdom and Ireland
Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita in Textbook of Palliative Medicine and Supportive Care, 2015
Cyclophosphamide is usually used for several solid tumors and lymphomas and has been associated with an acute cardiomyopathy that is associated with high doses and not related to cumulative dose. The incidence of cardiotoxicity may be particularly high in patients receiving cyclophosphamide as part of a program of high-dose chemotherapy followed by autologous stem cell rescue. Subsequent cardiac events can include hemorrhagic myopericarditis resulting in pericardial effusions, tamponade, and death, typically within the first week after treatment. Most pericardial effusions can be treated with glucocorticoids and analgesics without serious sequelae. These complications may be due to endothelial capillary damage.
Stemi mimicking post COVID: a case of focal myopericarditis post COVID infection
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Muhammad Atif Masood Noori, Abanoub Rushdy, Hardik Fichadiya, Sherif Roman, Islam Younes, Peter D. Lenchur, Peter M. Lenchur, Fayaz Shamoon
Given cardiac catheterization showed no significant coronary artery disease, the patient was admitted with a presumed diagnosis of myopericarditis. He was started on aspirin (81 mg once daily), Clopidogrel (75 mg once daily) and colchicine (0.6 mg twice daily). The next day, his troponins started trending down, but ST-elevation persisted in inferior and lateral leads. A transthoracic echocardiogram (TTE) demonstrated left ventricular ejection fraction (LVEF) of 40–45%, mildly decreased globular left ventricular systolic function and moderate to severe hypokinesis involving inferior, inferoposterior wall without thinning of myocardium (Video 1 & 2). Enalapril (2.5 mg once daily) and carvedilol (3.125 mg twice daily) were added to the treatment regimen.
Admission and follow-up cardiac magnetic resonance imaging findings in BNT162b2 Vaccine-Related myocarditis in adolescents
Published in Infectious Diseases, 2023
Seval Özen, Ayşe Esin Kibar Gül, Belgin Gülhan, Nilgün Işıksalan Özbülbül, Saliha Kanık Yüksek, Harun Terin, Özlem Mustafaoğlu, Pınar Bayraktar, İbrahim Ece, İbrahim İlker Çetin, Fatih Üçkardeş, Gülsüm İclal Bayhan, Aslınur Özkaya Parlakay
Developing and administering vaccines is highly important for a solution to the COVID-19 pandemic and a return to the normal. Although the safety of vaccines in general have been proven, comprehensive research on potential adverse effects is going on. In this study, we report 9 myopericarditis cases developing in adolescent male patients after different doses of the BNT162b2 vaccine. Myocarditis has various causes, including infectious and autoimmune aetiologies. The most prevalent causes of viral myocarditis in children are enterovirus, adenovirus, Parvovirus B19, EBV, CMV and HHV-6 infections [16]. Most myocarditis cases are idiopathic, and despite substantial research, an exact cause cannot be typically identified [17]. As an adverse effect, myopericarditis has been researched for years as it is included in several case reports in both adults and children following the administration of various vaccines. Albeit rarely, previously developed vaccines have also been associated with myocarditis. In history, it was reported that smallpox vaccines were associated with a significant number of myopericarditis cases both the first dose and repeated doses [18]. Following the administration of mRNA COVID-19 vaccines, patients usually present typically with chest pain, palpitations and high troponin levels within the first week after their second dose. They are mostly hemodynamically stable, and their symptoms and cardiac biomarkers return to normal in a few days [19]. All our patients had chest pain. The elevations in their CRP and cardiac biomarker values were typical. Their median time of presenting to the hospital was 3 days. They were discharged after being monitored for a median time of 7 days without requiring intensive care.
Azacitidine-induced myopericarditis in acute myeloid leukemia
Published in Baylor University Medical Center Proceedings, 2022
Mahmoud Ismayl, Asmini KC, Abhishek Thandra, Nattapong Sricharoen, Amy Arouni
Myopericarditis is defined as inflammation of the pericardium and heart muscle, which can be acute, subacute, or chronic and can involve focal or diffuse areas of myocardium.5 Myopericarditis is uncommon and has a wide spectrum of presentations ranging from simple fever or chest pain to fatal cardiogenic shock or arrhythmias.5 The etiology of myopericarditis can be infectious (viral/bacterial) and noninfectious, including systemic diseases, toxins, and drugs.
Related Knowledge Centers
- Acam2000
- Myocarditis
- Pericardial Effusion
- Pericarditis
- Pneumonia
- Tonsillitis
- Smallpox Vaccine
- Gastroenteritis
- Electrocardiography