43 Dressler’s syndrome post left atrial appendage occlusion: a rare diagnoses resurfaces
AbstractThree weeks post-procedure, an 85 year old male developed a new pericardial effusion. Infectious and malignant causes were excluded. Cytology demonstrated mixed inflammatory cells and a diagnosis of DS was made. One-month and six-month clinical review with trans-oesophageal echocardiogram (T...
Gespeichert in:
| Veröffentlicht in: | Heart (British Cardiac Society) 2022-10, Vol.108 (Suppl 3), p.A36-A37 |
|---|---|
| Hauptverfasser: | , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | A37 |
|---|---|
| container_issue | Suppl 3 |
| container_start_page | A36 |
| container_title | Heart (British Cardiac Society) |
| container_volume | 108 |
| creator | O’Regan, J O’Sullivan, C |
| description | AbstractThree weeks post-procedure, an 85 year old male developed a new pericardial effusion. Infectious and malignant causes were excluded. Cytology demonstrated mixed inflammatory cells and a diagnosis of DS was made. One-month and six-month clinical review with trans-oesophageal echocardiogram (TOE) showed sustained resolution of the pericardial effusion. DS is a rarely reported complication of LAAO.BackgroundDressler’s Syndrome also known as post myocardial infarction syndrome is a secondary pericarditis that can occur after cardiac myocyte damage. Such damage can occur after a myocardial infarction or routine endovascular surgery. It can present with or without pericardial effusion. DS has a significantly declining incidence due to the improved and more aggressive revascularisation techniques currently in use. This case was an iatrogenic cause via an intracardiac intervention. This intervention was a left atrial appendage occlusion (LAAO) with the AMPLATZER amulet device. LAAO is indicated for patients who are at risk of bleeding and who cannot tolerate long term oral anticoagulation. DS is a rare complication of the LAAO procedure with one study documenting a |
| doi_str_mv | 10.1136/heartjnl-2022-ICS.43 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_bmj_j</sourceid><recordid>TN_cdi_proquest_journals_2724301687</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2724301687</sourcerecordid><originalsourceid>FETCH-LOGICAL-b1153-cacfad001b61f134099544b17d6c897c4b30820c7f1f92c560e15c81286c85143</originalsourceid><addsrcrecordid>eNpFkM9KxDAQh4MouK6-gYeA564zSZqm3mT9t7DgQQUPQknTdG3ptjVpD9724kP4evskZlnF0wzz-_gNfIScI8wQubx8t9oNddtEDBiLFvOnmeAHZIJCqnDC18Ow8ziOJPDkmJx4XwOASJWckDfBt5uvG2e9b6zbbr499Z9t4bq1pX3nB9rYcqB6cJVuqO572xZ6ZWlnTDP6qmuvqKZOO0uLSq_azltPQ9foSm2sPyVHpW68PfudU_Jyd_s8f4iWj_eL-fUyyhFjHhltSl0AYC6xRC4gTWMhckwKaVSaGJFzUAxMUmKZMhNLsBgbhUyFPEbBp-Ri39u77mO0fsjqbnRteJmxhAkOKFUSKNhT-br-BxCyncPsz2G2c5gFh5ng_AcM32j8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2724301687</pqid></control><display><type>article</type><title>43 Dressler’s syndrome post left atrial appendage occlusion: a rare diagnoses resurfaces</title><source>PubMed Central</source><creator>O’Regan, J ; O’Sullivan, C</creator><creatorcontrib>O’Regan, J ; O’Sullivan, C</creatorcontrib><description>AbstractThree weeks post-procedure, an 85 year old male developed a new pericardial effusion. Infectious and malignant causes were excluded. Cytology demonstrated mixed inflammatory cells and a diagnosis of DS was made. One-month and six-month clinical review with trans-oesophageal echocardiogram (TOE) showed sustained resolution of the pericardial effusion. DS is a rarely reported complication of LAAO.BackgroundDressler’s Syndrome also known as post myocardial infarction syndrome is a secondary pericarditis that can occur after cardiac myocyte damage. Such damage can occur after a myocardial infarction or routine endovascular surgery. It can present with or without pericardial effusion. DS has a significantly declining incidence due to the improved and more aggressive revascularisation techniques currently in use. This case was an iatrogenic cause via an intracardiac intervention. This intervention was a left atrial appendage occlusion (LAAO) with the AMPLATZER amulet device. LAAO is indicated for patients who are at risk of bleeding and who cannot tolerate long term oral anticoagulation. DS is a rare complication of the LAAO procedure with one study documenting a <1% incidence. Along with one case report highlighting DS as a complication post ligation of the left atrial appendage with a LARIAT suture. These were the only recorded associations found on literature review. The aim of this case report is to increase the awareness of DS as a potential complication to medical and surgical staff conducting LAAO in the process of improving patient care.Case PresentationAn 85 year old man with a history of ischaemic stroke, dyslipidaemia, gout and pernicious anaemia presented with a background of melena secondary to peptic ulcer disease (PUD) and epistaxis while on Apixaban 2.5mg twice daily oral anticoagulation for permanent atrial fibrillation. A successful procedure was carried out and the patient was recommenced on Apixaban 2.5mg twice daily for six weeks. Three weeks post procedure, the patient presented with fever, pleuritic chest pain and dyspnoea. On TOE, a significant pericardial effusion was noted. The pericardial effusion was monitored and was found to be increasing in size along with a deteriorating blood pressure of below 90 systolic. An emergent pericardiocentesis using the subxiphoid approach was performed. a further 24 hours with a follow up echocardiogram indicated. Investigations figure 1- TOE demonstrates the LAAO device being inserted. Figures 2 and 3 show four week post procedure TOE highlights the new pericardial effusion with no rupture of the device in situ.DiscussionThe patient was noted to suffer from the autoimmune condition pernicious anaemia. Autoimmune conditions are frequently encountered in tandem with each other, with one paper stating the a second autoimmune condition will be present in 25% of patients. While gout is not autoimmune, it is inflammatory. Chronic inflammation can similarly predispose a patient to dysfunction in the inflammatory response. It may be theorised that in this case, the patient was at a higher risk of developing a disease like DS given their clinical history.Abstract 43 Figure 1Day zero. Amplatzer amulet device placementAbstract 43 Figure 24 weeks post procedure. Nil device issueAbstract 43 Figure 34 weeks post procedure. Pericardial Effusion. ICSGP1.9 (25)ConclusionThe association of DS as a complication post LAAO is exceptionally rare. Its uniqueness may be attributable to several causal factors including its ability to mimic more common conditions, along with its declining incidence via improved revascularisation techniques.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2022-ICS.43</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Anemia ; Case reports ; General posters ; Heart attacks ; Pericarditis ; Rheumatism ; Ultrasonic imaging</subject><ispartof>Heart (British Cardiac Society), 2022-10, Vol.108 (Suppl 3), p.A36-A37</ispartof><rights>Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>O’Regan, J</creatorcontrib><creatorcontrib>O’Sullivan, C</creatorcontrib><title>43 Dressler’s syndrome post left atrial appendage occlusion: a rare diagnoses resurfaces</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>AbstractThree weeks post-procedure, an 85 year old male developed a new pericardial effusion. Infectious and malignant causes were excluded. Cytology demonstrated mixed inflammatory cells and a diagnosis of DS was made. One-month and six-month clinical review with trans-oesophageal echocardiogram (TOE) showed sustained resolution of the pericardial effusion. DS is a rarely reported complication of LAAO.BackgroundDressler’s Syndrome also known as post myocardial infarction syndrome is a secondary pericarditis that can occur after cardiac myocyte damage. Such damage can occur after a myocardial infarction or routine endovascular surgery. It can present with or without pericardial effusion. DS has a significantly declining incidence due to the improved and more aggressive revascularisation techniques currently in use. This case was an iatrogenic cause via an intracardiac intervention. This intervention was a left atrial appendage occlusion (LAAO) with the AMPLATZER amulet device. LAAO is indicated for patients who are at risk of bleeding and who cannot tolerate long term oral anticoagulation. DS is a rare complication of the LAAO procedure with one study documenting a <1% incidence. Along with one case report highlighting DS as a complication post ligation of the left atrial appendage with a LARIAT suture. These were the only recorded associations found on literature review. The aim of this case report is to increase the awareness of DS as a potential complication to medical and surgical staff conducting LAAO in the process of improving patient care.Case PresentationAn 85 year old man with a history of ischaemic stroke, dyslipidaemia, gout and pernicious anaemia presented with a background of melena secondary to peptic ulcer disease (PUD) and epistaxis while on Apixaban 2.5mg twice daily oral anticoagulation for permanent atrial fibrillation. A successful procedure was carried out and the patient was recommenced on Apixaban 2.5mg twice daily for six weeks. Three weeks post procedure, the patient presented with fever, pleuritic chest pain and dyspnoea. On TOE, a significant pericardial effusion was noted. The pericardial effusion was monitored and was found to be increasing in size along with a deteriorating blood pressure of below 90 systolic. An emergent pericardiocentesis using the subxiphoid approach was performed. a further 24 hours with a follow up echocardiogram indicated. Investigations figure 1- TOE demonstrates the LAAO device being inserted. Figures 2 and 3 show four week post procedure TOE highlights the new pericardial effusion with no rupture of the device in situ.DiscussionThe patient was noted to suffer from the autoimmune condition pernicious anaemia. Autoimmune conditions are frequently encountered in tandem with each other, with one paper stating the a second autoimmune condition will be present in 25% of patients. While gout is not autoimmune, it is inflammatory. Chronic inflammation can similarly predispose a patient to dysfunction in the inflammatory response. It may be theorised that in this case, the patient was at a higher risk of developing a disease like DS given their clinical history.Abstract 43 Figure 1Day zero. Amplatzer amulet device placementAbstract 43 Figure 24 weeks post procedure. Nil device issueAbstract 43 Figure 34 weeks post procedure. Pericardial Effusion. ICSGP1.9 (25)ConclusionThe association of DS as a complication post LAAO is exceptionally rare. Its uniqueness may be attributable to several causal factors including its ability to mimic more common conditions, along with its declining incidence via improved revascularisation techniques.</description><subject>Anemia</subject><subject>Case reports</subject><subject>General posters</subject><subject>Heart attacks</subject><subject>Pericarditis</subject><subject>Rheumatism</subject><subject>Ultrasonic imaging</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpFkM9KxDAQh4MouK6-gYeA564zSZqm3mT9t7DgQQUPQknTdG3ptjVpD9724kP4evskZlnF0wzz-_gNfIScI8wQubx8t9oNddtEDBiLFvOnmeAHZIJCqnDC18Ow8ziOJPDkmJx4XwOASJWckDfBt5uvG2e9b6zbbr499Z9t4bq1pX3nB9rYcqB6cJVuqO572xZ6ZWlnTDP6qmuvqKZOO0uLSq_azltPQ9foSm2sPyVHpW68PfudU_Jyd_s8f4iWj_eL-fUyyhFjHhltSl0AYC6xRC4gTWMhckwKaVSaGJFzUAxMUmKZMhNLsBgbhUyFPEbBp-Ri39u77mO0fsjqbnRteJmxhAkOKFUSKNhT-br-BxCyncPsz2G2c5gFh5ng_AcM32j8</recordid><startdate>20221006</startdate><enddate>20221006</enddate><creator>O’Regan, J</creator><creator>O’Sullivan, C</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group LTD</general><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>20221006</creationdate><title>43 Dressler’s syndrome post left atrial appendage occlusion: a rare diagnoses resurfaces</title><author>O’Regan, J ; O’Sullivan, C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1153-cacfad001b61f134099544b17d6c897c4b30820c7f1f92c560e15c81286c85143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Anemia</topic><topic>Case reports</topic><topic>General posters</topic><topic>Heart attacks</topic><topic>Pericarditis</topic><topic>Rheumatism</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Regan, J</creatorcontrib><creatorcontrib>O’Sullivan, C</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Regan, J</au><au>O’Sullivan, C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>43 Dressler’s syndrome post left atrial appendage occlusion: a rare diagnoses resurfaces</atitle><jtitle>Heart (British Cardiac Society)</jtitle><stitle>Heart</stitle><date>2022-10-06</date><risdate>2022</risdate><volume>108</volume><issue>Suppl 3</issue><spage>A36</spage><epage>A37</epage><pages>A36-A37</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>AbstractThree weeks post-procedure, an 85 year old male developed a new pericardial effusion. Infectious and malignant causes were excluded. Cytology demonstrated mixed inflammatory cells and a diagnosis of DS was made. One-month and six-month clinical review with trans-oesophageal echocardiogram (TOE) showed sustained resolution of the pericardial effusion. DS is a rarely reported complication of LAAO.BackgroundDressler’s Syndrome also known as post myocardial infarction syndrome is a secondary pericarditis that can occur after cardiac myocyte damage. Such damage can occur after a myocardial infarction or routine endovascular surgery. It can present with or without pericardial effusion. DS has a significantly declining incidence due to the improved and more aggressive revascularisation techniques currently in use. This case was an iatrogenic cause via an intracardiac intervention. This intervention was a left atrial appendage occlusion (LAAO) with the AMPLATZER amulet device. LAAO is indicated for patients who are at risk of bleeding and who cannot tolerate long term oral anticoagulation. DS is a rare complication of the LAAO procedure with one study documenting a <1% incidence. Along with one case report highlighting DS as a complication post ligation of the left atrial appendage with a LARIAT suture. These were the only recorded associations found on literature review. The aim of this case report is to increase the awareness of DS as a potential complication to medical and surgical staff conducting LAAO in the process of improving patient care.Case PresentationAn 85 year old man with a history of ischaemic stroke, dyslipidaemia, gout and pernicious anaemia presented with a background of melena secondary to peptic ulcer disease (PUD) and epistaxis while on Apixaban 2.5mg twice daily oral anticoagulation for permanent atrial fibrillation. A successful procedure was carried out and the patient was recommenced on Apixaban 2.5mg twice daily for six weeks. Three weeks post procedure, the patient presented with fever, pleuritic chest pain and dyspnoea. On TOE, a significant pericardial effusion was noted. The pericardial effusion was monitored and was found to be increasing in size along with a deteriorating blood pressure of below 90 systolic. An emergent pericardiocentesis using the subxiphoid approach was performed. a further 24 hours with a follow up echocardiogram indicated. Investigations figure 1- TOE demonstrates the LAAO device being inserted. Figures 2 and 3 show four week post procedure TOE highlights the new pericardial effusion with no rupture of the device in situ.DiscussionThe patient was noted to suffer from the autoimmune condition pernicious anaemia. Autoimmune conditions are frequently encountered in tandem with each other, with one paper stating the a second autoimmune condition will be present in 25% of patients. While gout is not autoimmune, it is inflammatory. Chronic inflammation can similarly predispose a patient to dysfunction in the inflammatory response. It may be theorised that in this case, the patient was at a higher risk of developing a disease like DS given their clinical history.Abstract 43 Figure 1Day zero. Amplatzer amulet device placementAbstract 43 Figure 24 weeks post procedure. Nil device issueAbstract 43 Figure 34 weeks post procedure. Pericardial Effusion. ICSGP1.9 (25)ConclusionThe association of DS as a complication post LAAO is exceptionally rare. Its uniqueness may be attributable to several causal factors including its ability to mimic more common conditions, along with its declining incidence via improved revascularisation techniques.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><doi>10.1136/heartjnl-2022-ICS.43</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1355-6037 |
| ispartof | Heart (British Cardiac Society), 2022-10, Vol.108 (Suppl 3), p.A36-A37 |
| issn | 1355-6037 1468-201X |
| language | eng |
| recordid | cdi_proquest_journals_2724301687 |
| source | PubMed Central |
| subjects | Anemia Case reports General posters Heart attacks Pericarditis Rheumatism Ultrasonic imaging |
| title | 43 Dressler’s syndrome post left atrial appendage occlusion: a rare diagnoses resurfaces |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T20%3A39%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_bmj_j&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=43%E2%80%85Dressler%E2%80%99s%20syndrome%20post%20left%20atrial%20appendage%20occlusion:%20a%20rare%20diagnoses%20resurfaces&rft.jtitle=Heart%20(British%20Cardiac%20Society)&rft.au=O%E2%80%99Regan,%20J&rft.date=2022-10-06&rft.volume=108&rft.issue=Suppl%203&rft.spage=A36&rft.epage=A37&rft.pages=A36-A37&rft.issn=1355-6037&rft.eissn=1468-201X&rft_id=info:doi/10.1136/heartjnl-2022-ICS.43&rft_dat=%3Cproquest_bmj_j%3E2724301687%3C/proquest_bmj_j%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2724301687&rft_id=info:pmid/&rfr_iscdi=true |