Perimyocarditis after COVID-19 mRNA Vaccine: The Role of Cardiac Magnetic Resonance Imaging

A 22-year-old male presented with chest pain 3 days after his second dose of the COVID-19 vaccine. Cardiac magnetic resonance imaging demonstrated myocardial and pericardial enhancement. Given imaging and clinical findings, he was diagnosed with perimyocarditis. He was treated with a multitude of medications including NSAIDs, colchicine, and steroids. Fortunately, he was able to achieve symptom improvement. Due to COVID-19 vaccination novelty, further research is needed to identify side effects.</jats:p

Post-Cardiac Injury Syndrome after Surgical Repair of Atrial Septal Defect: Reporting a Rare Occurrence

A 16-year-old male with past medical history of congenital atrial septal defect surgical repair presented with recurrent pericarditis secondary to post-cardiotomy injury syndrome (PCIS). After failing medical therapy, he ultimately underwent pericardiectomy for symptom resolution. PCIS is underdiagnosed in children and should be considered in patients with recurrent chest pain.</jats:p

Abstract 17352: Seasonal Trends of Acute Idiopathic Pericardial Effusion Requiring Pericardial Drainage

Background: The seasonal trends of idiopathic pericardial effusion (PEff) are not known. Small PEff is usually asymptomatic but moderate to large PEff may lead to cardiac tamponade necessitating pericardial drainage procedures. Seasonal variations of PEff can help identify the association with viral infections that follow a seasonal pattern. Therefore, we sought to characterize the seasonal trends of moderate to large PEff. Methods: We retrospectively identified pericardial effusion patients from January 2015 to December 2019. Moderate to large PEff was defined as PEff requiring either pericardiocentesis or pericardial window. Patients with minimal to small PEff, autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis), cardiac surgeries/invasive procedures, hemopericardium, chronic pericarditis, malignancy, and metastasis were excluded. Data was acquired from electronic medical records and frequencies, means, percentages, and chi-square test statistics were calculated. Results: Of the 472 patients with PEff, 63% (n=296) were males and 37% (n=176) females. The median age was 61 years. Pericardiocentesis was performed in 65% of patients and 35% had pericardial window. All seasons had similar incidence of PEff (winter 27%, spring 25%, summer 24%, fall 23%, [X 2 =1.81, p=0.612]). The incidence also remained same across all the quarters of the year (Q1 25%, Q2 25%, Q3 26%, Q4 24%, [X2=0.119, p=0.990). The incidence of pericardiocentesis and pericardial window in winter (27% vs 27.5), Spring (22% vs 31%), summer (26% vs 20%), fall (25% vs 20%) showed no difference (X2=6.40, p=0.094). Conclusion: The incidence of moderate to large acute idiopathic pericardial effusion is consistent across all seasons and quarters. Similarly, no significant seasonality was associated with pericardiocentesis and pericardial window procedures. </jats:p

Cardiovascular Complications With Delivery Hospitalizations in Patients With Pulmonary Hypertension: A Nationwide Study From 2011 to 2020.

BACKGROUND: Pregnancy in patients with pulmonary hypertension (PH) is associated with a heightened risk of medical complications including right heart failure, pulmonary edema, and arrhythmias. Our study investigated the association between PH and these complications during delivery. METHODS AND RESULTS: The National Inpatient Sample was used to identify delivery hospitalizations from 2011 to 2020. Multivariable logistic regression was performed to study the association of PH with the primary outcomes of in-hospital medical and obstetric complications. A total of 37 482 207 delivery hospitalizations in women ≥18 years of age were identified, of which 9593 patients had PH. Pregnant patients with PH had higher incidence of complications during delivery including preeclampsia/eclampsia, arrhythmias, and pulmonary edema among others, compared with those without PH. Pregnant patients with PH also had a higher incidence of in-hospital mortality compared with those without PH (0.51% versus 0.007%). In propensity-matched analyses, PH was still significantly associated with a higher risk of in-hospital mortality (odds ratio [OR], 5.02 [95% CI, 1.82-13.90]; CONCLUSIONS: Delivery hospitalizations in patients with PH are associated with a high risk of mortality, pulmonary edema, peripartum cardiomyopathy, venous thromboembolism, arrhythmias, acute kidney injury, preeclampsia/eclampsia, and acute coronary syndrome

An Unusual Case of Parasitic Constrictive Pericarditis

Parasitic constrictive pericarditis is a rare entity. We present a case of a 75-year-old man who presented with dyspnea, ascites, and pedal edema and was found to have constrictive pericarditis on multimodality imaging with positive serology for Strongyloides Stercoralis. Treatment required ivermectin and radical pericardiectomy with significant clinical improvement. (Level of Difficulty: Intermediate.