Ibrahim Michel, Fattouh Michael, Jacobs Alice
Department of Medicine, Cardiovascular Division, Temple University Hospital, Philadelphia, PA, USA.
Montefiore Medical Center, Bronx, NY, USA.
Case Rep Cardiol. 2022 Mar 22;2022:5791307. doi: 10.1155/2022/5791307. eCollection 2022.
The evidence on recurrent pregnancy-related pericarditis is limited, and management strategies are based on case reports and expert opinion. We describe a patient with myopericarditis complicated by cardiac tamponade presenting shortly after her first pregnancy, which was then complicated by refractory recurrent pericarditis. She was treated with standard first line therapies, such as NSAIDs, corticosteroids, and colchicine, and eventually initiated on the purine analog, azathioprine. Out of fear of teratogenicity, she self-discontinued her maintenance medications and thereafter, her course was complicated by a recurrent flare of pericarditis during a subsequent pregnancy. Our case illustrates the significant burden on our patient due to the incessant nature of her disease and on the providers due to the therapeutic dilemmas associated with family planning and pregnancy. Further data is required on this unique clinical scenario, and patient-centered management by a multidisciplinary team is critical.
复发性妊娠相关性心包炎的证据有限，管理策略基于病例报告和专家意见。我们描述了一名患者，她在首次怀孕后不久出现心肌心包炎并并发心脏压塞，随后又并发难治性复发性心包炎。她接受了非甾体抗炎药、皮质类固醇和秋水仙碱等标准一线治疗，最终开始使用嘌呤类似物硫唑嘌呤。出于对致畸性的担忧，她自行停用了维持药物，此后，在随后的一次怀孕中，她的心包炎复发，病情变得复杂。我们的病例说明了她的疾病的持续性给患者带来的巨大负担，以及与计划生育和怀孕相关的治疗困境给医护人员带来的负担。需要针对这种独特的临床情况获取更多数据，多学科团队以患者为中心的管理至关重要。
