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2011, Number 4

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Rev Mex Cardiol 2011; 22 (4)

Non-ischemic oppressive chest pain (tuberculous pericarditis). Case report

Villalobos SJA, Ibarra GJ, Galván RA, LCamacho MLA

Language: Spanish
References: 22
Page: 185-192
PDF size: 167.26 Kb.


ABSTRACT

Farmer of 76 years sent to emergency department with crushing, diaphoresis, chest pain without irradiation of two weeks of evolution, accompanied by dyspnea, dry cough, irritated and unquantificated fever with evening predominance, increased abdominal girth, lower limb edema and pericardial effusion by echocardiography 750 mL. The computed tomography of the chest showed thickening of the pericardium, right pleural effusion and ascites fluid on paracolic sliding. We proceed with partial pericardiectomy and we drained 300 mL of citrine fluid with lymphocyte predominant exudate 72%, adenosine deaminase 90 U/L. The surgical specimen shows thickening of pericardium of approximately 18 mm, necrosis with inflammatory infiltration of lymphoid cells, granuloma formation and caseus necrosis, confirming the diagnosis of tuberculous pericarditis. Treatment was initiated with broad spectrum antibiotics, tuberculoustatics drugs and systemic steroid. The patient was discharged for improvement. No echocardiogram is done because the initial data showed no myocardial dysfunction.


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