Echocardiography monitoring for diazoxide induced pericardial effusion
. BMJ Case Rep 2012;2012.
To our knowledge, this is the first case in the literature about peripheral edema along with pericardial effusion
associated with olanzapine.
Low voltage ECG, T wave flattening and T wave inversion are ECG abnormalities usually seen in pericardial effusion
and revert to normal after initiation of hormone replacement therapy before biochemical correction of hypothyroidism2.
This was evidenced in this bird, where atherosclerosis is one of several suspected causes that may have led to the bird being in congestive heart failure, and pericardial effusion
is suspected to have been an effect of the heart failure.
Perhaps, the most dramatic case report was a 20-year-old female with recent diagnosis of lupus (with active myositis treated with oral prednisone and azathioprine) who presented with acute myocarditis as evidenced by an ejection fraction of 15% and large pericardial effusion
. Left and right cardiac catheterization was unremarkable, but she required intraaortic balloon pump and soon developed cardiogenic shock.
Viral etiology of this condition is possible but unlikely because usually foetal viral myocarditis causes global cardiomegaly, heart failure, or arrhythmias and massive pericardial effusion
. As already reported by Blondheim et al.
Chest CT showed a large pericardial effusion
that was compressing the ventricles and the right atrium.
is another common finding that is found in 43% of patients .
The etiology of pericardial effusion
among the 32 study patients included 11 infections, 9 systemic inflammatory diseases, 2 tumors/malignancy, 2 cardiomyopathies, and 6 undetermined etiologies including 2 with underlying malignancy (Table 1).
Parasternal long axis view of transthoracic echocardiogram showing large circumferential pericardial effusion
with evidence for tamponade physiology.
A bedside cardiac ultrasound was performed which demonstrated a large pericardial effusion
with tamponade physiology (Figure 2).
Ultrasound examination showed fluid in the abdominal cavity together with bladder wall thickening (Figure 1), hepatomegaly, and pleural and pericardial effusion
. Computed tomography confirmed all these findings (Figure 2).