Chronic Effusive Pericarditis and Chronic Constrictive Pericarditis

Chronic Pericarditis is inflammation that begins gradually, is long lasting and results in fluid accumulation in the pericardial space or thickening of the pericardium. The etiology is unknown but may be cancer, TB or hypothyroidism. Arrhythmias are common and seen in almost half the patients. The commonest arrhythmia is atrial fibrillation. Symptoms and signs are related to increased right atrial pressure and physical findings include elevated JVP and pericardial knock. Non surgical therapy consists mainly of no salt. Surgery cures about 85% of patients, however 5–15% of patients will die. Chronic effusive pericarditis occurs when there is persistent restriction of the visceral pericardium after pericardiocentesis

Sudden Cardiac Death in Adult Patients with Stable Ischemic Heart Disease

There are approximately one half million patients with stable ischemic heart disease (SIHD) in the United States. Patients with stable ischemic heart disease who die suddenly do not maintain a Stable Ischemic profile. Benchimol, et al., reported 319 consecutive stable angina patients without clinical heart failure or a recent myocardial infarction but who had multiple risk factors and proven coronary disease which made them more prone to acute myocardial infarction or unstable angina. In the APSIS (angina prognosis in Stockholm) study, Hjemdahl reported that signs of ischemia or previous manifestations of coronary artery disease, i.e., myocardial infarction or revascularization, were found in 69% of both male and female patients at baseline. Little, retrospectively reported that minor plaques may disrupt and result in unstable angina or occlusive coronary disease which then may result in acute myocardial infarction. Stable angina patients, by definition, are stable and are not high risk unless they have multiple factors or which may make them prone to evolve an acute coronary syndrome or develop a serious arrhythmia but sudden death does occur in some patients