Silva Ana Sofia, Reis Sofia, Lima Rosélia, Jesus Guilherme, Santos Lígia R
Internal Medicine, Unidade Local de Saúde de Gaia e Espinho, Vila Nova de Gaia, PRT.
Cureus. 2025 Apr 30;17(4):e83236. doi: 10.7759/cureus.83236. eCollection 2025 Apr.
Acute pericarditis is the most common pericardial disease, presenting with varied manifestations and potentially indicative of systemic disease. A 56-year-old male with a history of hypertension, dyslipidemia, type 2 diabetes, and a former smoker presented with chest pain relieved by leaning forward, fever, elevated inflammatory markers, and electrocardiographic changes consistent with acute pericarditis. Initial treatment with acetylsalicylic acid and colchicine resulted in a favorable clinical response with improvement in inflammatory markers. However, symptoms later worsened, accompanied by night sweats and weight loss. Imaging revealed a nonspecific pulmonary lesion in the right upper lobe and consolidation in the left lower lobe with associated pleural effusion. Pleural fluid analysis indicated an exudate, predominated by mononuclear cells, with negative cytology. A guided biopsy confirmed lung adenocarcinoma. This case underscores the importance of a holistic approach to acute pericarditis, with an emphasis on etiological investigation in atypical presentations.
急性心包炎是最常见的心包疾病，表现多样，可能提示全身性疾病。一名56岁男性，有高血压、血脂异常、2型糖尿病病史，既往吸烟，因前倾位胸痛缓解、发热、炎症标志物升高以及符合急性心包炎的心电图改变前来就诊。初始使用阿司匹林和秋水仙碱治疗后临床反应良好，炎症标志物有所改善。然而，症状后来恶化，伴有盗汗和体重减轻。影像学检查显示右上叶有非特异性肺部病变，左下叶实变并伴有胸腔积液。胸腔积液分析显示为渗出液，以单核细胞为主，细胞学检查阴性。经引导活检确诊为肺腺癌。该病例强调了对急性心包炎采取整体方法的重要性，尤其要重视非典型表现时的病因调查。
