D'Souza Melroy S, Shinn Kaitlin, Patel Anup D
Department of Internal Medicine, Emory University, Atlanta, Georgia 30307.
Emory University School of Medicine, Emory University, Atlanta, Georgia 30307.
Tex Heart Inst J. 2020 Jun 1;47(3):233-235. doi: 10.14503/THIJ-19-7002.
Effusive-constrictive pericarditis is typically caused by tuberculosis or other severe inflammatory conditions that affect the pericardium. We report a case of effusive-constrictive pericarditis consequent to a motor vehicle accident. A 32-year-old man with gastroesophageal reflux disease presented with severe substernal chest pain of a month's duration and dyspnea on exertion for one week. Echocardiograms revealed a moderate pericardial effusion, and the diagnosis was subacute effusive-constrictive pericarditis. After thorough tests revealed nothing definitive, we learned that the patient had been in a motor vehicle accident weeks before symptom onset, which made blunt trauma the most likely cause of pericardial injury and effusion. Medical management resolved the effusion and improved his symptoms. To our knowledge, this is the first report of effusion from posttraumatic constrictive pericarditis associated with a motor vehicle accident. We encourage providers to consider recent trauma as a possible cause of otherwise idiopathic pericarditis.
渗出性缩窄性心包炎通常由结核病或其他影响心包的严重炎症性疾病引起。我们报告一例因机动车事故导致的渗出性缩窄性心包炎病例。一名患有胃食管反流病的32岁男性，出现持续一个月的严重胸骨后胸痛，且在活动后呼吸困难一周。超声心动图显示中度心包积液，诊断为亚急性渗出性缩窄性心包炎。在全面检查未发现明确病因后，我们了解到该患者在症状出现前数周曾发生机动车事故，这使得钝性创伤成为心包损伤和积液最可能的原因。药物治疗使积液消退并改善了他的症状。据我们所知，这是首例与机动车事故相关的创伤后缩窄性心包炎导致积液的报告。我们鼓励医疗人员将近期创伤视为不明原因心包炎的可能病因。
