Journal of Cardiology Cases最新文献

{"title":"Improvement of acute hemolysis after mechanical valve replacement by prosthesis rotation without redo replacement","authors":"Ryusuke Hosoda MD ,&nbsp;Takaya Hoashi MD, PhD ,&nbsp;Koichi Toda MD ,&nbsp;Akinori Hirano MD, PhD ,&nbsp;Yuji Fuchigami MD ,&nbsp;Yukino Iijima MD ,&nbsp;Takaaki Suzuki MD, PhD","doi":"10.1016/j.jccase.2026.01.009","DOIUrl":"10.1016/j.jccase.2026.01.009","url":null,"abstract":"<div><div><em>A</em>1-year-old female with a partial atrioventricular septal defect and a borderline left ventricular size underwent a left-sided atrioventricular valve plasty at four months. Due to persistent regurgitation, a reoperation was performed at one year for left-sided atrioventricular valve replacement. The valve was implanted in an anti-anatomical position and the side of the posterior wall translocated toward the left atrium because of a narrow annulus. Postoperative course was initially good, but lactate dehydrogenase levels significantly rose to 2262 U/L by postoperative day 14. Echocardiography revealed mild paravalvular leakage on the septal and left atrial sides. A greater regurgitant jet was observed from the posterior left atrial hinge compared to the septal side. Reoperation was performed for mechanical valve adjustment on postoperative day 17. The left atrial wall side, suspected of paravalvular leakage, was broadly reinforced with felt strips. Intraoperative transesophageal echocardiography still showed significant regurgitation from the left atrial hinge. The mechanical valve was rotated 40 degrees counterclockwise. Post-rotation, the regurgitant jet significantly decreased. Lactate dehydrogenase normalized, and resolution of transvalvular leakage and associated hemolysis was confirmed. This case highlights the complexity of mechanical valve implantation in challenging anatomies and the importance of addressing subtle leaks.</div></div><div><h3>Learning objective</h3><div><em>A</em>1-year-old female with a partial atrioventricular septal defect and borderline left ventricular size underwent a left-sided atrioventricular valve replacement. Postoperatively, she developed hemolysis, which was suspected to be caused by transvalvular leakage. A reoperation involving valve rotation and paravalvular leakage repair resolved the hemolysis. It is possible that the specific structure of the mechanical valve contributed to the hemolysis, warranting further investigation.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 5","pages":"Pages 152-155"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757099","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":"Thrombocytosis-associated ticagrelor non-responder status after ECMO-supported primary PCI in STEMI","authors":"Christoph Strohhofer MD ,&nbsp;Hannes Alber MD ,&nbsp;Jakob Dörler MD","doi":"10.1016/j.jccase.2026.01.015","DOIUrl":"10.1016/j.jccase.2026.01.015","url":null,"abstract":"<div><div>Despite established treatment pathways for ST-elevation myocardial infarction (STEMI), complications range from adverse events such as malignant cardiac arrhythmias to more elusive risks such as thrombocytosis compromising antiplatelet efficacy. We describe a case of ticagrelor non-responsiveness in a patient who developed critical reactive thrombocytosis after veno-arterial extracorporeal membrane oxygenation–supported percutaneous coronary intervention for inferior STEMI. High on-treatment platelet reactivity was detected by Multiplate (Roche Diagnostics, Mannheim, Germany) testing at a time when the platelet count exceeded 1.1 × 10⁶/μl. Given the absence of alternative platelet function platforms at the treatment center, prasugrel was introduced based on the available test results, with subsequent normalization of platelet function. Unlike clopidogrel and prasugrel, resistance to ticagrelor has rarely been reported. This case highlights the need for individualized antiplatelet strategies in high-risk profiles.</div></div><div><h3>Learning objective</h3><div>Ticagrelor may present a pharmacodynamic challenge in patients with thrombocytosis. In very high-risk patients, particularly those with atypical hematologic profiles, verifying the efficacy of platelet aggregation inhibition through laboratory testing is essential.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 5","pages":"Pages 160-163"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757101","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":"Intracoronary urokinase infusion during prolonged perfusion balloon inflation for massive thrombus in acute myocardial infarction: case series","authors":"Sae Ujiro MD ,&nbsp;Hiroyuki Yamamoto MD, PhD ,&nbsp;Hiroto Kinutani MD, PhD ,&nbsp;Tomofumi Takaya MD, PhD","doi":"10.1016/j.jccase.2026.01.016","DOIUrl":"10.1016/j.jccase.2026.01.016","url":null,"abstract":"<div><div>Primary percutaneous coronary intervention remains the cornerstone of management in ST-segment elevation myocardial infarction (STEMI). However, thrombus-rich lesions frequently impede optimal reperfusion, increasing the risk of procedural complications and limiting the achievement of Thrombolysis in Myocardial Infarction grade 3 flow. Various adjunctive techniques—including thrombus aspiration, prolonged balloon inflation, excimer laser coronary angioplasty, and intracoronary thrombolysis—have been employed in such scenarios. This case series describes two STEMI patients treated with a novel approach: intracoronary infusion of low-dose urokinase (60,000 units) during prolonged (10-min) inflation with a perfusion balloon (Ryusei, Kaneka, Osaka, Japan), which maintains distal perfusion during dilation. This strategy effectively achieved reperfusion and thrombus resolution while minimizing myocardial ischemia and reducing stent length. In contrast to conventional high-dose thrombolysis, this method enables localized low-dose delivery (60,000 units), potentially enhancing drug retention and tissue penetration. These cases suggest that intracoronary infusion of low-dose urokinase during perfusion balloon inflation may represent a safe and effective adjunctive strategy for managing thrombus-rich lesions in STEMI.</div></div><div><h3>Learning objective</h3><div>To present an innovative technique involving intracoronary infusion of urokinase during prolonged perfusion balloon inflation. This strategy enables simultaneous compression of the culprit plaque and thrombolysis, potentially leading to improved outcomes in STEMI with a high thrombus burden. Additionally, lesion-selective infusion of urokinase through perfusion balloon microholes allows effective thrombolysis with a lower urokinase dose compared to standard administration.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 5","pages":"Pages 139-142"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756999","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 unique infective etiology for cardiomyopathy in a South Asian patient","authors":"Gulbadin Mufti MD, DM,&nbsp;A. Shaheer Ahmed MD, DM, DNB","doi":"10.1016/j.jccase.2026.01.017","DOIUrl":"10.1016/j.jccase.2026.01.017","url":null,"abstract":"<div><div>Left ventricular (LV) dysfunction can occur due to various causes. In order to provide appropriate treatment, it is essential to establish the correct etiology of LV dysfunction. A 52-year-old male, resident of South India, presented with dyspnea on exertion for two months. Echocardiography showed global LV hypokinesia with ejection fraction of 45% and global longitudinal strain (GLS) of −12.5%. Coronary angiogram (CAG) showed single-vessel disease of right coronary artery. The CAG findings were inconsistent with distribution of LV dysfunction. There was also history of fever and migratory polyarthritis involving large joints of upper and lower limbs 2–3 months previously. Hemogram revealed mild anemia with iron deficiency. Erythrocyte sedimentation rate was elevated (100 mm/h). Lyme serology (IgM) results were positive. Fundus examination showed cotton wool spots bilaterally. Upper gastrointestinal endoscopy and biopsy indicated duodenitis. Diagnosis of Lyme cardiomyopathy was made. All the findings in our patient are explained by Lyme disease including cardiomyopathy, history of fever with polyarthritis, duodenitis, and cotton wool spots on fundus. The patient received doxycycline for 3 weeks. Subsequent follow ups for LV function showed improvement in LV ejection fraction from 45% to 52%. GLS improved from −12.5% to −15%.</div></div><div><h3>Learning objective</h3><div>All cases of left ventricular dysfunction should be thoroughly evaluated. Infectious diseases can also underlie left ventricular dysfunction. It is essential to confirm a history of fever and joint symptoms. In cases with migratory polyarthritis, Lyme disease should be suspected, and fundus examination together with Lyme serology testing can lead to diagnosis and appropriate treatment.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 5","pages":"Pages 143-146"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757000","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 case of off-pump CABG performed in a super-elderly patient with suspected metal allergy and angina","authors":"Fumiko Yoshimachi MD ,&nbsp;Shohei Ikeda MD, PhD ,&nbsp;Nao Yanagisawa MD ,&nbsp;Shuka Seto MD ,&nbsp;Kazuki Furuyama MD ,&nbsp;Issei Fujita MD ,&nbsp;Keisuke Suzuki MD, PhD ,&nbsp;Hiroshi Nakagata MD, PhD ,&nbsp;Kosuke Aoki MD ,&nbsp;Eiji Sato MD, PhD ,&nbsp;Yoshihiro Yamashina MD, PhD ,&nbsp;Takehiko Miyashita MD, PhD ,&nbsp;Yoshiaki Mibiki MD, PhD ,&nbsp;Akihiko Ishida MD ,&nbsp;Tetsuo Yagi MD, PhD ,&nbsp;Shuji Toyama MD, PhD","doi":"10.1016/j.jccase.2026.01.019","DOIUrl":"10.1016/j.jccase.2026.01.019","url":null,"abstract":"<div><div>The patient was an 86-year-old woman who presented to our hospital with exertional chest pain as her chief complaint. Her medical history was notable for diabetes mellitus. Transthoracic echocardiography revealed reduced wall motion in the lateral and inferolateral walls, with a decreased left ventricular ejection fraction. Although her symptoms improved temporarily with nitrate administration, optimal medical therapy failed to achieve sufficient relief. Coronary angiography showed 90% stenosis in the left anterior descending artery (segments #6–7) and the left circumflex artery (segment #11), along with a chronic total occlusion in the right coronary artery (segment #2). These findings indicated a clear need for coronary revascularization. Subsequent medical history-taking suggested a suspected metal allergy. After heart team conference, off-pump coronary artery bypass grafting (CABG) without the use of metal materials was chosen and successfully performed, due to her advanced age and the allergy concern. Postoperatively, her chest pain resolved completely, and she was discharged in good condition after completing a rehabilitation program. This case highlights the feasibility of off-pump CABG without metallic implants in super-elderly patients with complex coronary artery disease and underscores the importance of individualized, heart team–based decision-making when metal allergy is a concern.</div></div><div><h3>Learning objective</h3><div>This case demonstrates the feasibility of metal-free off-pump coronary artery bypass grafting in a super-elderly patient with complex coronary artery disease. It emphasizes the role of multidisciplinary heart team discussions and shared decision-making when patient-specific concerns, including suspected metal allergy, influence revascularization strategies.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 5","pages":"Pages 177-180"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757105","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":"Contrasting anatomical challenges in the implantation of tine-fixed and helix-fixed leadless pacemakers in a single patient: A case report","authors":"Takafumi Oka MD, PhD ,&nbsp;Makoto Nagayoshi MSc ,&nbsp;Ryota Ogihara MSc ,&nbsp;Takayuki Sekihara MD ,&nbsp;Kentaro Ozu MD ,&nbsp;Tomoaki Nakano MD ,&nbsp;Yasushi Sakata MD, PhD, FJCC","doi":"10.1016/j.jccase.2025.12.007","DOIUrl":"10.1016/j.jccase.2025.12.007","url":null,"abstract":"<div><div>Patient-specific anatomical variations can significantly influence the implantation technique of different types of leadless pacemakers (LPMs). A 74-year-old man with complete atrioventricular block initially underwent successful implantation of a tine-fixed LPM. Three years later, an elevated pacing threshold caused premature battery depletion, and a helix-fixed LPM was selected for reimplantation. Unlike the tine-fixed LPM implantation procedure, this implantation proved technically challenging. The catheter developed a sigmoid deformation while crossing the tricuspid valve, which subsequently made manipulation at the interventricular septum difficult. This deformation was resolved by alternating retraction and advancement of the protective sleeve, leading to successful device implantation. We considered that the technical challenges were attributable to the inferior vena cava axis being oriented toward the posterior atrial wall and interatrial septum—directing the delivery catheter away from the tricuspid valve—in combination with the larger curvature of the helix-fixed LPM delivery system.</div></div><div><h3>Learning objective</h3><div>Compared with tine-fixed leadless pacemakers, helix-fixed systems may be more susceptible to anatomical challenges during implantation. Pre-implantation assessment of anatomical features might be helpful for the procedures.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 4","pages":"Pages 115-119"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578651","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":"Coexistence and spontaneous transition between orthodromic atrioventricular reentrant tachycardia and atrial tachycardia: The mechanism of atrial activation sequence","authors":"Daiki Yamashita MD ,&nbsp;Yoshihiko Kagawa MD, PhD ,&nbsp;Yuma Tsumagari BS ,&nbsp;Shinichi Harada MD ,&nbsp;Fumiya Uchida BHS ,&nbsp;Kaoru Dohi MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.01.008","DOIUrl":"10.1016/j.jccase.2026.01.008","url":null,"abstract":"<div><div>The coexistence of multiple supraventricular tachycardias during electrophysiological study (EPS) is rare and can complicate diagnosis and treatment. We present a case of coexisting orthodromic atrioventricular reentrant tachycardia (AVRT) and atrial tachycardia (AT) with spontaneous transitions. A 15-year-old girl with palpitations underwent EPS revealing orthodromic AVRT via a left-sided accessory pathway (AP) and AT originating from the right atrium. The tachycardias had similar cycle lengths and exhibited spontaneous transitions. During AT, a unique cyclic atrial activation sequence was observed, hypothesized to result from fusion of antegrade AT conduction and retrograde conduction via a left-sided AP. Radiofrequency catheter ablation targeting the AP successfully terminated the arrhythmias, with no recurrence observed during follow-up. This case highlights the complex electrophysiological interplay between coexisting AVRT and AT, the mechanism of spontaneous tachycardia transitions, and the unique cyclic fusion atrial activation pattern resulting from combined antegrade AT conduction and retrograde conduction via a left-sided AP.</div></div><div><h3>Learning objective</h3><div>This case highlights the complex electrophysiological interplay between coexisting atrioventricular reentrant tachycardia and atrial tachycardia (AT), the mechanism of spontaneous tachycardia transitions, and the unique cyclic fusion atrial activation pattern resulting from combined antegrade AT conduction and retrograde conduction via a left-sided accessory pathway.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 4","pages":"Pages 120-123"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578652","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":"Ruptured infected external iliac artery aneurysm following total hip arthroplasty successfully treated with endovascular stent graft placement: A case report","authors":"Takeshi Okura MD,&nbsp;Toshitaka Okabe MD, PhD,&nbsp;Naoei Isomura MD, PhD,&nbsp;Masahiko Ochiai MD, PhD, FJCC","doi":"10.1016/j.jccase.2026.01.012","DOIUrl":"10.1016/j.jccase.2026.01.012","url":null,"abstract":"<div><div>Although rare, infected aneurysm formation following hip arthroplasty is a serious complication that can be life-threatening. The current patient was a 58-year-old woman who had undergone left hip arthroplasty 7 years earlier and bilateral hip arthroplasty 3 years earlier. She presented with pain in her left lower leg. She was diagnosed with left hip joint dislocation and admitted for revision surgery. After admission blood tests revealed elevated inflammatory markers and progressive anemia, and worsening swelling and pain in the left lower leg. Computed tomography revealed a ruptured aneurysm of the left external iliac artery. It was hypothesized that a periprosthetic joint infection had contributed to the development and rupture of the aneurysm. She underwent endovascular therapy using a stent graft. The infected artificial hip joint was then surgically removed, and antimicrobial therapy was administered. Her condition improved after treatment. One of the major concerns with stent graft treatment in infected aneurysms is the persistence of infected tissue. While endovascular therapy can be effective, debridement of infected lesions remains the standard approach for long-term infection control. We suggest that stent graft placement may be a viable treatment option in selected cases.</div></div><div><h3>Learning objective</h3><div>Infected aneurysm formation after hip arthroplasty is rare. In the current emergent case of aneurysmal rupture, considering the patient's overall condition, we initially opted for endovascular stent graft placement. In the event that the infection was not controlled, secondary surgical replacement with an artificial graft was planned. The case demonstrates the potential utility of such a staged treatment strategy.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 4","pages":"Pages 132-134"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578583","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 case of diffuse large B-cell lymphoma with cardiac tumor presenting tachycardia-bradycardia syndrome associated with atrial fibrillation","authors":"Shuka Seto MD ,&nbsp;Shohei Ikeda MD, PhD ,&nbsp;Nao Yanagisawa MD ,&nbsp;Kazuki Furuyama MD ,&nbsp;Issei Fujita MD ,&nbsp;Keisuke Suzuki MD, PhD ,&nbsp;Hiroshi Nakagata MD, PhD ,&nbsp;Kosuke Aoki MD ,&nbsp;Eiji Sato MD, PhD ,&nbsp;Yoshihiro Yamashina MD, PhD ,&nbsp;Takehiko Miyashita MD, PhD ,&nbsp;Yoshiaki Mibiki MD, PhD ,&nbsp;Akihiko Ishida MD ,&nbsp;Tetsuo Yagi MD, PhD ,&nbsp;Makiko Tsukita MD, PhD ,&nbsp;Joji Yamamoto MD, PhD ,&nbsp;Masahiro Rokugo MD, PhD","doi":"10.1016/j.jccase.2026.01.004","DOIUrl":"10.1016/j.jccase.2026.01.004","url":null,"abstract":"<div><div>We report a rare case of diffuse large B-cell lymphoma (DLBCL) presenting with both nasal and cardiac tumors. The patient was a 77-year-old man who initially visited a local clinic with a two-month history of right-sided nasal discharge and nasal obstruction. A tumor lesion was identified in the nasal cavity, and he was subsequently referred to our hospital. Blood tests revealed leukocytosis, and computed tomography demonstrated a right nasal tumor, multiple lymphadenopathies, and an irregular mass in the right atrium. A biopsy of the nasal lesion confirmed the diagnosis of DLBCL. Transthoracic echocardiography revealed a relatively immobile cardiac mass, approximately 50 mm in diameter, located in the right atrium, which was suspected to represent cardiac infiltration of lymphoma. Chemotherapy with polatuzumab vedotin in combination with rituximab, cyclophosphamide, doxorubicin, and prednisone was initiated. During the clinical course, the patient exhibited tachycardic atrial fibrillation and sinus pauses lasting up to approximately six seconds, suggesting tachycardia–bradycardia syndrome. With ongoing chemotherapy, the cardiac tumor showed a marked reduction in size over time. To date, the patient has been successfully managed without pacemaker implantation. This case suggests that careful management, including close monitoring, is crucial for arrhythmias associated with cardiac involvement of malignant lymphoma.</div></div><div><h3>Learning objective</h3><div>We encountered a rare case of malignant lymphoma with a cardiac tumor complicated by tachycardia–bradycardia syndrome and atrial fibrillation. Tumor reduction was achieved through chemotherapy, and careful observation allowed management without pacemaker implantation. This case highlights the need for cautious and individualized clinical judgment in the management of arrhythmias associated with cardiac lymphoma.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 4","pages":"Pages 107-110"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578649","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":"Effusive-constrictive pericarditis in a patient with late-onset systemic lupus erythematosus","authors":"Eli Reynolds MD, MPH ,&nbsp;Michael Garshick MD ,&nbsp;Joey Junarta MBBS","doi":"10.1016/j.jccase.2025.12.006","DOIUrl":"10.1016/j.jccase.2025.12.006","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is associated with increased cardiac morbidity and mortality and involves a range of cardiac pathologies. The most common of these is a simple pericardial effusion, though rarely this can be complicated by constrictive pericarditis. We present a case illustrating a rare SLE-mediated effusive-constrictive pericarditis. A 70-year-old female with a history of a prior stroke and coronary artery disease presented with 2 weeks of dyspnea, pleuritic chest pain, and fever. Her labs were notable for acute kidney injury with hematuria and proteinuria, elevated inflammatory markers, positive anti-nuclear antibody, low complement levels, and positive double-stranded DNA. CT scan of the chest showed circumferential pericardial effusion with echocardiogram and right heart catheterization confirming effusive-constrictive pericarditis. Clinically, she met diagnostic criteria for SLE and additionally underwent renal biopsy that confirmed SLE nephritis. The patient was started on colchicine, hydroxychloroquine, mycophenolate mofetil, and prednisone. A 3-month follow-up echocardiogram demonstrated resolution of the pericardial effusion and constrictive physiology. Effusive-constrictive pericarditis is a rare but important manifestation of pericardial disease in SLE. Treatment of the underlying SLE led to the resolution of the pericardial pathology.</div></div><div><h3>Learning objective</h3><div>Systemic lupus erythematosus (SLE) is a heterogeneous illness that causes significant morbidity and mortality across a variety of organ systems. Our aim is to educate clinicians on the spectrum of cardiac manifestations in SLE with a particular focus on pericardial disease. Using our case as a reference, we hope to highlight developments in diagnosis and management of pericardial disease in SLE.</div></div>","PeriodicalId":52092,"journal":{"name":"Journal of Cardiology Cases","volume":"33 4","pages":"Pages 111-114"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578650","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}