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Radiation Pericarditis

Presentation

This two volume set presents recent advances in the knowledge and technology related to the field of cardiology. [books.google.com]

Here we present a rare case of constrictive pericarditis of possible tuberculous etiology and review the diagnosis and management of the condition. [alliedacademies.org]

A moderate pericardial effusion was also present. Figure 1 Cardiac magnetic resonance imaging. (A) At diagnosis. (B) Pre-radiation. (C) Post-radiation. (D) 40 months post-radiation. [pagepress.org]

Cardiovascular

  • Chest Pain

    Of note, the patient states that after the surgery, he had resolution of his chest pain, but he has started experiencing chest pain again. [medbullets.com]

    Inflammation of this membrane may cause chest pain. [chemocare.com]

    Pericarditis causes chest pain and a high temperature (fever). It's not usually serious, but it can cause complications. Get medical advice if you have chest pain. [nhs.uk]

    In such cases, the patient may not have the typical chest pain, but may experience tiredness, shortness of breath, and coughing. [news-medical.net]

    I hope your doctor is able to find a way to resolve your breathing and chest pain issues. I know it is uncomfortable (to say the least), and worrisome for you. Once again, welcome to DC! Kathy [drugs.com]

  • Pericardial Friction Rub

    Fever, pericardial friction rub and improvement with nonsteroidal anti-inflammatory drugs characterized the patients with idiopathic pericarditis. [osti.gov]

    Signs The typical auscultory finding of pericarditis is the "Pericardial Friction Rub" which is observed as a high-pitched, scratching sound likely caused by the inflamed pericardial layers rubbing against one another. [pathwaymedicine.org]

    There is often a pericardial friction rub with serial changes on the electrocardiogram. In dry pericarditis the friction rub is distinct, caused by deposits of fibrin, and may be heard through a stethoscope. [medical-dictionary.thefreedictionary.com]

    Pericardial friction: characteristics of pericardial rubs in 50 consecutive, prospectively studied patients. N Engl J Med 1968;278:1204–1207. A study of various features of pericardial friction rubs in 50 consecutive patients with pericarditis. [tele.med.ru]

    The most common physical finding that helps confirm the diagnosis of pericarditis is a pericardial friction rub. Inflammation prevents the two layers of pericardium from easily sliding against each other with each heartbeat. [medicinenet.com]

Workup

1859 Infectious Agents and Cancer 549 1860 Cancer of the Skin 1863 Melanoma 1889 Diagnostic Studies and Pretreatment Staging 1001 1908 Principles of Isolation Perfusion 701 1923 Intraocular Melanomas 1951 Invasion and Metastasis 117 1952 Metastatic WorkUp [books.google.com]

Failure of conventional medical therapy for CHF often follows an extensive diagnostic workup, leading to the final diagnosis of constrictive pericarditis. [emedicine.medscape.com]

At the end of the workup, the diagnoses were idiopathic pericarditis in seven patients, neoplastic pericarditis in four, radiation pericarditis in two, postsurgical pericarditis in one, and tuberculous pericarditis in one ( Table 2 ). [nejm.org]

X-Ray

  • Pericardial Effusion

    Abstract We report surgical management of radiation-induced massive pericardial effusion. [jstage.jst.go.jp]

    Treatment Pericarditis with large effusion can be drained either percutaneously or surgically Those with recurrent pericardial effusion can be treated with pericardiotomy (pericardial window) or by surgical stripping. [wikidoc.org]

    Causes There are many causes of pericardial effusions. [verywell.com]

    I have recurring bouts with pericardial effusion, but do not have scarring or chronic inflammation. I've always been treated with Mobic. A couple of times my cardiologist gave me a round of prednisone for the inflammation causing the effusion. [drugs.com]

    If a pericardial biopsy is indicated, simultaneous drainage of pericardial effusion can be performed. Specific therapy is directed at the underlying cause of the pericardial effusion. [tele.med.ru]

Treatment

Left thoracotomy is an effective alternative to median sternotomy for the surgical treatment of radiation pericarditis, with a mild increase in pulmonary-associated complications. [ncbi.nlm.nih.gov]

Image source: imagina / MorgueFile.com I was contacted this week by one of my Facebook fans, a lady who is 44, normally in good health, but currently undergoing radiation treatments for breast cancer. [marnieclark.com]

[…] of pericarditis following ; HEART/radioinduced inflammation of pericardium of human, following therapy of Hodgkin's disease, surgical treatment for ; MAN/radioinduced pericarditis in, following therapy for Hodgkin's disease, surgical treatment for ; [osti.gov]

As more patients are surviving cancer and living longer, knowledge about the long-term effects of treatment is expanding. [my.clevelandclinic.org]

Prognosis

Prognosis The prognosis of a pericardial effusion depends largely on the cause. With infections, inflammatory disease, or kidney disease that can be managed, the prognosis may be very good. [verywell.com]

Prognosis Most patients with acute pericarditis (generally those with presumed viral or idiopathic pericarditis) have a good long-term prognosis [6]. [escardio.org]

Systemic lupus erythematosus (SLE) and scleroderma also may lead to constrictive pericarditis; in the latter case, the prognosis is poor. [emedicine.medscape.com]

Prognosis is strongly linked to the underlying cause but long-term survival is more likely with surgery and the best results are achieved if surgery is offered early. [patient.info]

What Is the Average Prognosis? The common prognosis for the pericardial type is poor, compared to that of peritoneal or pleural mesothelioma. Nearly 50 to 60 percent of pericardial patients pass away within six months of receiving a diagnosis. [asbestos.com]

Etiology

Overview Pericarditis can be caused by both infectious and noninfectious etiologies. [pathwaymedicine.org]

The etiology was idiopathic in ten subjects and secondary to carcinomatous encasement, chronic renal failure, purulent infection and tuberculosis in one patient each (Group B, N = 14). Meang age was 53.4 [+-] 15.5 years. [osti.gov]

Other tests are performed based on clinical suspicion of a specific etiology or to exclude certain etiologies. [brown.edu]

Here we present a rare case of constrictive pericarditis of possible tuberculous etiology and review the diagnosis and management of the condition. [alliedacademies.org]

In fact, this etiologic spectrum reflects, to a certain extent, the general etiologic spectrum of pericardial diseases in each area and can be influenced by the changing etiologic spectrum of pericarditis in general and constrictive pericarditis in particular [nejm.org]

Epidemiology

Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis. Annals of Epidemiology, 27(5):348-359. doi: 10.1016/j.annepidem.2017.04.001 Nambiar, C. et al. (1992). Primary pericardial mesothelioma: One-year event-free survival. [asbestos.com]

Carcinoma of the Vulva 1528 Cancer of the Uterine Body 1543 Chemoprevention 609 1545 Uterine Sarcomas 1557 Gestational Trophoblastic Diseases 1564 Colon Cancer 1232 1574 Epothilones 455 1586 Genetic Predisposition 1390 1595 Epidemiology 1232 1604 Malignant [books.google.com]

Epidemiology and Demographics Incidence of radiation induced pericarditis has significantly decreased with the use of lower doses and newer radiotherapy techniques [3] [4]. [wikidoc.org]

Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]

"As the epidemiological studies do not give clues on the important mechanisms underlying RIHD, it is difficult to design preventive strategies. [medicalphysicsweb.org]

Pathophysiology

It brings together the pathophysiology of disease with detailed clinical guidance on diagnosis and management for the full range of childhood cancers, including aspects important in optimal supportive care. [books.google.com]

Pathophysiology Radiation exposure causes endothelial damage, capillary rupture, and platelet adhesion which initiates an inflammatory response and leads to development of adhesions between the two membranes of pericardium. [wikidoc.org]

The pathophysiology remains poorly understood, but radiation "might harm virtually all cardiac tissues and the underlying pathophysiological mechanisms may be related to micro- and macrovascular damages," they explained. [medicalphysicsweb.org]

But endothelial cells remain sensitive to radiation, and the pathophysiology of most forms of RIHD appears to be associated with damage to endothelial cells. [mdedge.com]

Pathophysiology and Classification Depending on the underlying cause, the acute inflammatory response in pericarditis may produce serous fluid, pus, or dense fibrinous material. [aafp.org]

Prevention

Clear back in the 1960s, it became known that, after receiving adjuvant radiation to prevent breast cancer recurrence, quite a few women were dying of heart disease, often decades after their breast cancer diagnosis (Fajardo 2001). [marnieclark.com]

The scarring constricts the movement of the heart during each heartbeat and can prevent the heart from expanding to accept blood returning from the body after each heartbeat. [medicinenet.com]

Role of cardioprotective therapy for prevention of cardiotoxicity with chemotherapy: A systematic review and meta-analysis. Eur J Cancer [Internet]. 2013 Sep [cited 2018 Dec 18];49(13):2900-9. [scielo.cl]

This tissue helps to anchor the heart in place, prevents excessive movement of the heart in the chest when body position changes, protects the heart from infections and tumors that develop in and may spread from nearby tissues, and may help keep the heart [healthcommunities.com]

Keeping on top of standard risk factors — like smoking, blood pressure, cholesterol, weight, physical activity, diet, and stress — can help prevent the appearance of heart disease. [health.harvard.edu]

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