Orme Joseph, Eddin Moneer, Loli Akil
Department of Internal Medicine, Banner Good Samaritan Medical Center, Phoenix, Arizona, USA.
Department of Cardiology, Banner Good Samaritan Medical Center, Phoenix, Arizona, USA.
N Am J Med Sci. 2014 Sep;6(9):481-3. doi: 10.4103/1947-2714.141653.
Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction.
A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient's presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine.
This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation.
局限性心包炎难以捉摸且诊断困难。医疗服务提供者应熟悉心脏消融术后并发症,因为该手术目前已广泛开展且经常进行。局限性心包炎的治疗与急性心肌梗死有很大不同。
一名52岁男性接受了房颤消融术,术后第二天出现严重的胸骨后胸痛,心电图表现提示急性心肌梗死,随后进行了冠状动脉造影、左心室造影和二维经胸超声心动图检查,所有检查均无异常,未发现阻塞性冠状动脉疾病、室壁运动异常或心包积液。最终,该患者被诊断为局限性心包炎。诊断后,患者的症状通过包括非甾体抗炎药和秋水仙碱在内的治疗得以缓解。
这是首例关于心脏消融术后局限性心包炎的病例研究报告。心电图表现为典型的急性心肌梗死;然而,冠状动脉造影和左心室造影未显示急性冠状动脉闭塞或室壁运动异常。医疗专业人员必须记住,心包炎的心电图表现并不总是典型的,且心包炎可发生于心脏消融术后。