Journal of Cardiology Cases最新文献

{"title":"Endocardial ablation-resistant ivabradine-sensitive atrial tachycardia suggestive of an epicardial origin in the left atrial appendage","authors":"Kohki Nakamura MD, PhD, FJCC ,&nbsp;Takehito Sasaki MD ,&nbsp;Kentaro Minami MD, PhD ,&nbsp;Taiki Masuyama MD, PhD ,&nbsp;Shingo Yoshimura MD ,&nbsp;Keiji Hoshino MD ,&nbsp;Akiko Kodama MD ,&nbsp;Yuji Matsuo MD ,&nbsp;Kenichi Kaseno MD, PhD ,&nbsp;Suguru Nishiuchi MD, PhD ,&nbsp;Shigeto Naito MD, PhD","doi":"10.1016/j.jccase.2025.05.006","DOIUrl":"10.1016/j.jccase.2025.05.006","url":null,"abstract":"<div><div>A 23-year-old woman presented with 200,409 heart beats/day due to an atrial tachycardia (AT) lasting one year and tachycardia-induced cardiomyopathy. None of the antiarrhythmic or rate control drugs terminated the AT or sufficiently reduced the heart rate during the AT. Thus, she underwent radiofrequency catheter ablation of the AT. Ultra-high-resolution mapping suggested that the AT originated from the epicardial left atrial appendage (LAA), and endocardial radiofrequency ablation failed to eliminate the AT, although acceleration and transient termination of the AT during ongoing ablation in the endocardial LAA were observed. After the ablation, ivabradine monotherapy achieved both an optimal heart rate control during the AT and termination of the AT. Some ATs refractory to conventional antiarrhythmic drug therapy can be treated by ivabradine and are called ivabradine sensitive-ATs (ISATs). Left atrial ISATs often originate from the vicinity of the LAA and have been reported to be treated by endocardial radiofrequency ablation. This case report describes that a subset of ISATs originating from the LAA may be associated with epicardial abnormal automaticity and refractory to conventional endocardial radiofrequency ablation.</div></div><div><h3>Learning objective</h3><div>Some focal atrial tachycardias (ATs) refractory to conventional antiarrhythmic drug therapy are successfully treated by ivabradine and are called ivabradine sensitive-ATs (ISATs). ISATs originating from the left atrial appendage (LAA) have been reported to be eliminated by endocardial radiofrequency ablation, but a subset of LAA-ISATs may be associated with epicardial abnormal automaticity and may be refractory to endocardial radiofrequency ablation.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 91-95"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptomatic esophagogastric hypomotility a year after cryoablation for atrial fibrillation: a case report","authors":"Shinya Sugiura MD PhD ,&nbsp;Naoki Fujimoto MD PhD, FJCC ,&nbsp;Kazuki Fujioka ,&nbsp;Takashi Tanigawa MD PhD, FJCC ,&nbsp;Kaoru Dohi MD PhD, FJCC","doi":"10.1016/j.jccase.2025.05.001","DOIUrl":"10.1016/j.jccase.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Cryoballoon (CB) ablation is a safe and effective treatment for atrial fibrillation (AF). However, complications, such as esophagogastric hypomotility (EGH) secondary to vagal nerve injury (VNI), have been reported.</div></div><div><h3>Case summary</h3><div>We present the case of a 71-year-old woman with paroxysmal AF who underwent CB ablation. The patient did not report any gastrointestinal symptoms during the procedure. Precisely 4 months later, an upper gastrointestinal endoscopy during a routine health check revealed food retention in the stomach. Eleven months after the CB ablation, the patient was admitted to the emergency room on account of chest tightness. Computed tomography showed a large amount of food residue in the esophagus. Esophagogastroscopy revealed retained food in the esophagus without any apparent obstruction.</div></div><div><h3>Conclusion</h3><div>EGH, particularly secondary to VNI post CB ablation, poses diagnostic and management challenges. Our case highlights the limitations of current strategies in preventing EGH, including freeze duration, frequency adjustments, and esophageal temperature monitoring. Additionally, late-onset symptomatic EGH underscores the need for long-term follow-up care post CB ablation.</div></div><div><h3>Learning objective</h3><div>We present a case of asymptomatic gastric hypomotility, post-ablation, which developed symptomatic esophagogastric hypomotility one year after the procedure. Late-onset symptomatic esophagogastric, especially esophageal hypomotility have not been previously reported. Freeze duration, times and esophageal temperature monitoring may not avoid esophagogastric hypomotility. Esophagogastric motility disorders may persist longer than previously reported.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 70-74"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case of successful long-term outcome with Uhl's anomaly after total cavopulmonary connection with right ventricular exclusion","authors":"Mariko Saito MD ,&nbsp;Hiroaki Kise MD, PhD ,&nbsp;Minako Hoshiai MD, PhD ,&nbsp;Shoji Suzuki MD, PhD","doi":"10.1016/j.jccase.2025.05.005","DOIUrl":"10.1016/j.jccase.2025.05.005","url":null,"abstract":"<div><div>We report a case of Uhl's anomaly in a 24-year-old man with a hemodynamically stable condition achieved by total cavopulmonary connection (TCPC) with right ventricular (RV) exclusion. He presented with cyanosis shortly after birth. Severe RV enlargement and dysfunction were observed during early infancy. He underwent one and a half ventricular repair with partial RV resection at 9 months of age. Intraoperatively, the free wall of the right ventricle was enlarged and extremely thin. Pathological examination of the resected right ventricle revealed severe subendothelial fibrosis and a mildly degenerated myocardium, suggesting Uhl's anomaly. Following the surgery, the right ventricle was re-enlarged, accompanied by a decline in its function. The patient underwent TCPC with fenestration and RV exclusion at 6 years of age. The fenestration was surgically closed at 15 years of age due to his oxygen saturation dropping below 90 %. At the age of 24 years, the left ventricular ejection fraction was preserved without RV dilatation with New York Heart Association Class I even under univentricular circulation. In cases of Uhl's anomaly with severe RV dysfunction combined with a significantly degenerated RV myocardium, TCPC and RV exclusion should be one therapeutic option for a successful long-term outcome.</div></div><div><h3>Learning objective</h3><div>Uhl's anomaly is a cardiomyopathy of the right ventricle, with a poor prognosis and no treatment strategy. Appropriate surgical interventions are crucial particularly in the presence of right ventricular (RV) dysfunction, including refractory RV enlargement, worsened function, and significantly degenerated RV myocardium. In some cases, total cavopulmonary connection combined with RV exclusion contributes to reduce the impact of an enlarged right ventricle and lead to favorable long-term outcomes.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 87-90"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful weaning from hemodialysis by percutaneous transluminal renal angioplasty in a patient with a solitary kidney and acute kidney injury caused by renal artery occlusion","authors":"Kanako Yokomizo MD,&nbsp;Mayuko Imamura MD,&nbsp;Kei Yunoki MD, PhD,&nbsp;Ryuta Takenaka MD, PhD,&nbsp;Takefumi Oka MD, PhD","doi":"10.1016/j.jccase.2025.05.007","DOIUrl":"10.1016/j.jccase.2025.05.007","url":null,"abstract":"<div><div>There is no clear consensus on the indication for percutaneous transluminal renal angioplasty (PTRA) in cases of acute kidney injury caused by renal artery stenosis or occlusion in patients with a solitary kidney. A 79-year-old man with a solitary kidney presented with right back pain and anuria and was admitted to our hospital with a diagnosis of acute kidney injury. Because of progressive renal impairment and worsening fluid overload, hemodialysis was initiated the day after admission. Magnetic resonance angiography and ultrasonography indicated severe stenosis at the right renal artery ostium, and renal scintigraphy showed markedly reduced blood flow to the right kidney. Although the outcome was uncertain, PTRA was performed on day 8 because renal viability was suspected. Abdominal aortography revealed occlusion at the origin of the right renal artery, and a bare-metal stent was placed to restore blood flow. Following PTRA, renal function gradually improved, and the patient was successfully weaned from hemodialysis 1 week later. This case demonstrates that assessing renal blood flow with multimodality imaging and performing reperfusion therapy can be effective, even when there is a delay in treatment following the onset of renal ischemia.</div></div><div><h3>Learning objective</h3><div>Early revascularization is typically recommended for acute renal ischemia due to renal artery stenosis or occlusion in patients with a solitary kidney because delayed intervention may lead to irreversible renal function loss. However, the present case highlights that even when revascularization is delayed, renal viability can be assessed using multimodality imaging to evaluate blood flow, and revascularization may restore renal function in select cases.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 96-100"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase analysis with heart risk view function for cardiac resynchronization therapy: A case report","authors":"Tsuyoshi Ichihara MD ,&nbsp;Daisuke Tomioka MD ,&nbsp;Kazumasa Kobashi ,&nbsp;Takuma Nishikawa MD ,&nbsp;Yusuke Fuji MD, PhD ,&nbsp;Tomoya Ozawa MD, PhD ,&nbsp;Ichiro Nakae MD, PhD ,&nbsp;Yoshihisa Nakagawa MD, PhD","doi":"10.1016/j.jccase.2025.04.001","DOIUrl":"10.1016/j.jccase.2025.04.001","url":null,"abstract":"<div><div>Myocardial perfusion scintigraphy (MPS) is a valuable diagnostic tool for identifying stable angina and evaluating myocardial viability. In clinical practice, MPS-based analysis tools, such as the Heart Risk View (Nihon Medi-physics Co., Ltd., Tokyo, Japan), have proven effective in assessing left ventricular (LV) dyssynchrony. This case report illustrates the diagnostic utility of MPS in identifying and assessing LV dyssynchrony due to ventricular septal pacing for pacemaker implantation. Upon admission, the patient exhibited symptoms of heart failure (New York Heart Association Class II) due to a Wenckebach-type second-degree atrioventricular block, requiring dual-chamber pacemaker implantation with septal pacing. Eight months postoperatively, phase analysis using the Heart Risk View revealed a significantly reduced ejection fraction (EF: 30 %) and marked LV dyssynchrony [standard deviation width (PhSD): 86 degrees, histogram bandwidth (PhBW): 227 degrees]. Given the presentation of drug-resistant heart failure and asynchronous contraction, a cardiac resynchronization therapy (CRT) device was implanted. Immediately following CRT implantation, phase analysis demonstrated notable improvement in LV function (EF: 42 %) and LV dyssynchronous contraction (PhSD: 30 degrees, PhBW: 110 degrees).</div></div><div><h3>Learning objective</h3><div>This study investigated the utility of myocardial perfusion scintigraphy in diagnosing post-implantation dyssynchronous contractions and assessing treatment efficacy. This case underscores the potential for dyssynchrony due to ventricular pacing. It emphasizes the importance of regular reassessment for mechanical dyssynchrony, particularly in patients experiencing a severe decline in ejection fraction or exercise tolerance following pacemaker implantation. Early evaluation is crucial to determine the need for cardiac resynchronization therapy and prevent further deterioration.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 51-54"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary cardiac lymphoma presenting double obstruction of the right ventricle","authors":"Masaru Yoshikai MD, PhD ,&nbsp;Kazuyuki Ikeda MD ,&nbsp;Manabu Itoh MD, PhD ,&nbsp;Kouki Jinnouchi MD ,&nbsp;Fumito Arima MD ,&nbsp;Kouji Irie MD","doi":"10.1016/j.jccase.2025.04.002","DOIUrl":"10.1016/j.jccase.2025.04.002","url":null,"abstract":"<div><div>Primary cardiac lymphoma (PCL) is an extremely rare cardiac malignancy, typically associated with a poor prognosis. We present a case of PCL causing right heart failure due to obstruction of the inflow and outflow of the right ventricle. The tumor was highly mobile, prompting an urgent debulking surgery that was successfully performed. Subsequent chemotherapy was effective, leading to remission 8 months after presentation. Although chemotherapy is the standard treatment for PCL, surgical treatment should be considered for patients with PCL leading to heart failure due to tumor-induced hemodynamic instability and/or have highly mobile tumors to prevent sudden death from tumor embolisms.</div></div><div><h3>Learning objective</h3><div>We describe a case where primary cardiac lymphoma (PCL) presented with right heart failure due to obstruction of the inflow and outflow of the right ventricle. The case emphasizes the role of urgent surgical intervention even before chemotherapy to prevent sudden death. It stresses the importance of cardiologists and surgeons to be well-acquainted with the conditions necessitating surgical intervention in PCL cases.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 55-58"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart transplant in a patient with acute onset of heart failure and massive bi-ventricular thrombi: A case report","authors":"Shaden Daloub MD ,&nbsp;Rhythm Vasudeva MD ,&nbsp;Amandeep Goyal MD ,&nbsp;Emily Newton MD ,&nbsp;Hirak Shah MD ,&nbsp;Matthew Danter MD ,&nbsp;Tyler Zorn MD ,&nbsp;Timothy Fields MD ,&nbsp;Tarun Dalia MD","doi":"10.1016/j.jccase.2025.05.003","DOIUrl":"10.1016/j.jccase.2025.05.003","url":null,"abstract":"<div><div>Massive biventricular thrombi are a rare but serious complication of acute heart failure with reduced ejection fraction, presenting significant challenges in management. These thrombi can cause coronary thrombi leading to hemodynamic instability and raise the risk of systemic embolism. A 42-year-old male with a past medical history of type 2 diabetes mellitus presented with cardiogenic shock and pulmonary embolism. He was found to have new onset of heart failure with left ventricular ejection fraction of 15 % and harboring large biventricular thrombi. Stress test showed over 50 % of his myocardium was infarcted. Due to these findings, after a multidisciplinary team discussion, he was placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as bridge to orthotopic heart transplant (OHT), for hemodynamic support and prevention of distal embolization. He subsequently underwent OHT as an INTERMACS category 1 a few days later. This rare and complicated case highlights the importance of a multidisciplinary team approach, and utilization of VA-ECMO in an end-stage cardiomyopathy patient with large biventricular thrombi as bridge to OHT.</div></div><div><h3>Learning objective</h3><div>Veno-arterial extracorporeal membrane oxygenation can be utilized to prevent systemic embolization as a bridge to orthotopic heart transplant in patients with biventricular thrombus and end-stage cardiomyopathy.</div><div>Heart transplant can be a lifesaving treatment in a patient with biventricular thrombi and extensive non-viable myocardium.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 79-82"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac papillary fibroelastoma mimicking left ventricle apical thrombus","authors":"Salma El Manir MD ,&nbsp;Lionel Camilleri MD ,&nbsp;Phuoc Nguyen Le MD ,&nbsp;Charline Pujos MD ,&nbsp;Yann Barthelemy MD ,&nbsp;Etienne Geoffroy MD ,&nbsp;Thomas Chassagne MD ,&nbsp;Nicolas D'Ostrevy MD, PhD","doi":"10.1016/j.jccase.2025.04.004","DOIUrl":"10.1016/j.jccase.2025.04.004","url":null,"abstract":"<div><div>Papillary fibroelastomas (PFE) are one of the most common types of primary cardiac tumors. They are a potential cause of transient ischemic attacks (TIA), strokes, myocardial infarction, and sudden death. We report the case of a 64-year-old woman who suffered from a TIA 10 years previously and a stroke a few years later. Transthoracic echocardiography (TTE) revealed a mass compatible with a thrombus in the apex of the left ventricle. The rest of the etiological assessment was negative. Anticoagulation treatment was started along with a TTE and magnetic resonance imaging (MRI) follow up. The patient presented with a new ischemic stroke two months later, and MRI revealed an increase in mass. After multidisciplinary discussion, a surgical excision was performed, and the histological study revealed PFE. The postoperative course was uneventful, and the patient was discharged 10 days after surgery.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 59-61"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single report tells the story: Ventricular fibrillation caused by vasospastic angina recorded from an implantable loop recorder","authors":"Daiki Nakajima MD,&nbsp;Hitoshi Mori MD, PhD,&nbsp;Kazuhisa Matsumoto MD, PhD,&nbsp;Yoshifumi Ikeda MD, PhD,&nbsp;Ritsushi Kato MD, PhD","doi":"10.1016/j.jccase.2025.05.008","DOIUrl":"10.1016/j.jccase.2025.05.008","url":null,"abstract":"<div><div>Implantable loop recorders (ILRs) are essential for diagnosing unexplained syncope, particularly when cardiogenic causes are suspected. An 80-year-old male experienced unexplained syncope following chest tightness, with no obstructive coronary findings. A comprehensive cardiac evaluation failed to identify the underlying cause, however Holter electrocardiography showed non-sustained ventricular tachycardia, suggesting cardiogenic syncope. Therefore, we proceeded with ILR implantation. Ten days post-discharge, ILR monitoring detected ventricular fibrillation (VF) preceded by ST-T elevation and triggered by a premature ventricular contraction, confirming vasospastic angina (VSA) as the cause. This is the first documented case where VF due to VSA was diagnosed via a single ILR electrogram. ILRs thus play a crucial role in managing syncope.</div></div><div><h3>Learning objective</h3><div>Implantable loop recorder (ILR) is useful not only for diagnosing arrhythmias in unexplained syncope, but also for identifying underlying conditions causing the arrhythmias. In this case report, ventricular arrhythmias following ST-T elevation caused by vasospastic angina were detected through a single ILR report.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 101-103"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pericardial drainage and continuous irrigation for a patient with purulent pericarditis caused by Streptococcus anginosus","authors":"Kazuki Matsumura MD ,&nbsp;Hiroaki Kawano MD, PhD, FJCC ,&nbsp;Takahiro Muroya MD, PhD ,&nbsp;Shiro Hata MD, PhD ,&nbsp;Hiroki Shinboku MD, PhD ,&nbsp;Koichiro Sonoda MD, PhD ,&nbsp;Kentaro Furukawa MD ,&nbsp;Koji Maemura MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.04.008","DOIUrl":"10.1016/j.jccase.2025.04.008","url":null,"abstract":"<div><div>Pericarditis is a rare, rapidly progressing, life-threatening condition. A 49-year-old Japanese woman presented with heart failure resulting from cardiac effusion secondary to purulent pericarditis (bacterial pyogenic pericarditis) caused by <em>Streptococcus anginosus</em>. The patient required emergency pericardial drainage and irrigation. We report this case and discuss the available treatment options for this disease.</div></div><div><h3>Learning objectives</h3><div>Purulent pericarditis accounts for less than 1 % of all acute pericarditis cases because treatment methods against causative bacteria have already been established. However, purulent pericarditis continues to result in a poor prognosis and high mortality. <em>Streptococcus anginosus</em>, one of the normal floras can also induce purulent pericarditis, and we recommend pericardial drainage and continuous irrigation in addition to antibiotics as early as possible after the diagnosis, especially in patients with worsening of general condition.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"32 2","pages":"Pages 62-65"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}