Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2011     Vol 36     No 4
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      UDK 616.11-002-053.9 ; 616.5-002.5-06-053.9

ISSN 0350-2899, 36(2011) br.4 p.223-226

Case report

Exudative pericarditis with cardiac tamponade as a manifestation of systemic lupus erythematosus in elder patients
(Eksudativni perikarditis sa srčanom tamponadom kao manifestacija sistemskog eritemskog lupusa u starijoj životnoj dobi)

Sofija Subin-Teodosijević (1), Jelena Zvekić-Svorcan (2), Slavenka Petković-Ćurić (1),
Sanja Vrzić(1), Uroš Bačić (1)

(1) Opšta bolnica "Dr Đorđe Joanović", Zrenjanin, (2) Specijalna bolnica za reumatske bolesti, Novi Sad


  Download in a pdf format   Summary:
INTRODUCTION. Exudative pericarditis with cardiac tamponade is a rare manifestation of systemic lupus erythematosus, especially in older patients. Diagnosis criteria are hypotension, increase of systemic venous pressure, tachycardia with soft, barely audible heart sounds (the Becks triad), paradoxical pulse. Diagnosis is made after echocardiography, and timely intervention – pericardiocentesis may prevent a fatal outcome. THE CASE REPORT. An 80-year old female patient had a chest pain, stronger during inspiration, as well as cough, weakness, fatigue and painful edema in most peripheral joints. After clinical and laboratory tests, with chest RTG and echocardiography, a threatening cardiac tamponade was diagnosed. After hemodynamic stabilization, the patient was sent to the Clinic where pericardiocentesis was done, evacuating 670ml of effusion. After biochemical analyses of pericardial effusion and immunoserological analyses, when other diseases were eliminated, systemic lupus erythematosus (SLE) was diagnosed based on 4 out of 11 ACR criteria. Therefore glucocorticoid therapy started, bringing to clinic and echocardiographic reduction of fluid and reduction of polyarthritis. CONCLUSION. Cardiac tamponade due to exudative pericarditis with SLE is a rare, but life-threatening complication. Our aim is to emphasize the importance of early diagnosis, multidisciplinary approach in diagnostics and treatment, as well as the possibility of incidence in older age.
Key words: exudative pericarditis, cardiac tamponade, systemic lupus erythematosus

Napomena: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian

      Corresponding Address:
Sofija Subin – Teodosijević
Opšta bolnica "Dr Đorđe Joanović"
Dr Vase Savića 5, Zrenjanin
tel.: 060/5524553
Paper received: 16. 11. 2011
Paper accepted: 16. 01. 2012
Paper Internet issues: 20. 02. 2012
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Timočki medicinski glasnik, Zdravstveni centar Zaječar
Journal of Regional section of Serbian medical association in Zajecar
Rasadnička bb, 19000 Zaječar, Srbija

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