Abstract
A 28-year-old man was referred to a hospital because of acute illness, fever, malaise, and retrosternal chest pain. On the admission, he was eupnoic, the heart rate was 90 beats/min, and the blood pressure was 110/80 mm Hg. Chest roentgenographic findings were unremarkable, and electrocardiography showed near-ubiquitous ST segment (J point) elevations, diffuse PR segment depression and specular elevation in the aVR lead. On auscultation, no pericardial rub was evident. The following laboratory data were obtained: hemoglobin, 13.5 g/dl, leucocite count, 11 10/mm, erythrocyte sedimentation rate, 98 mm in 1 h. Echocardiography disclosed a large pericardial effusion (Fig. 1). The clinical features of active acute pericardial disease subsided with bed rest and nonsteroidal antiinflammatory drugs (ibuprofen 800 mg every 8 h). A specific cause was not apparent after assessment according to our internal diagnostic protocol [1]. Acute idiopathic pericarditis was diagnosed. Six days after, his conditions deteriorated: dyspnea, hypotension, and marked giugular venous distension were noted. The echocardio-
Highlights
The etiology and the clinical pattern of acute pericarditis change frequently and some classic assumption and descriptions are outdated
The clinical features of active acute pericardial disease subsided with bed rest and nonsteroidal antiinflammatory drugs
The evolution to cardiac constriction is a rare occurrence in acute idiopathic pericarditis as compared with other causes of pericardial disease [4]
Summary
The etiology and the clinical pattern of acute pericarditis change frequently and some classic assumption and descriptions are outdated. Echocardiography disclosed a large pericardial effusion (Fig. 1). The clinical features of active acute pericardial disease subsided with bed rest and nonsteroidal antiinflammatory drugs (ibuprofen 800 mg every 8 h). A specific cause was not apparent after assessment according to our internal diagnostic protocol [1].
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