Tuberculous pericarditis: Challenges and controversies in the modern era

Tuberculous pericarditis (TBP) continues to wreak havoc across Sub-Saharan Africa (SSA). Despite more than 5 decades of treatment and research into TBP, we are not much closer to alleviating the suffering and mortality associated with this extrapulmonary manifestation of tuberculosis (TB). In the era of modern cardiology, diseases of the pericardium do not receive the same amount of research attention and investment as what diseases of lifestyle do. Interventional techniques for their diagnosis and management do not extend much further than pericardiocentesis with appropriate laboratory investigations. They also do not provide the potential for the development and use of consumable equipment, or that of expensive drugs and, consequently, fi nancial investment into their research and development is not forthcoming. Diseases of the pericardium do, however, remain important within the discipline that we practice and TBP in particular deserves our continuous efforts and attention. It is unfortunate to acknowledge that we have not made much of an impact on this ancient foe over the last 50 odd years. Despite the World Health Organisation (WHO) declaring TB a global emergency in 1993, more than 20 years later we are not much better off. In 2013 an estimated 9 million people developed the disease and 1.5 million died from it.(1) TBP is predominantly a disease of SSA and it requires a solution from the very region which it torments

An approach to the patient with suspected pericardial disease

Diseases of the pericardium commonly manifest in one of three ways: acute pericarditis, pericardial effusion and constrictive pericarditis. In the developed world, the most common cause of acute pericarditis is viral or idiopathic disease, while in the developing world tuberculous aetiology, particularly in sub-Saharan Africa, is commonplace owing to the high prevalence of HIV. This article provides an approach to the diagnosis, investigation and management of these patients

An approach to the patient with suspected pericardial disease

Diseases of the pericardium commonly manifest in one of three ways: acute pericarditis, pericardial effusion and constrictive pericarditis. Inthe developed world, the most common cause of acute pericarditis is viral or idiopathic disease, while in the developing world tuberculousaetiology, particularly in sub-Saharan Africa, is commonplace owing to the high prevalence of HIV. This article provides an approach to thediagnosis, investigation and management of these patients

Tuberculous pericarditis : challenges and controversies in the modern era

CITATION: Kyriakakis, C. G. 2016. Tuberculous pericarditis : challenges and controversies in the modern era. SA Heart, 13(2):104-111, doi:10.24170/13-2-1672.The original publication is available at http://www.journals.ac.za/index.php/SAHJTuberculous pericarditis (TBP) continues to wreak havoc across Sub-Saharan Africa (SSA). Despite more than 5 decades of treatment and research into TBP, we are not much closer to alleviating the suffering and mortality associated with this extrapulmonary manifestation of tuberculosis (TB). In the era of modern cardiology, diseases of the pericardium do not receive the same amount of research attention and investment as what diseases of lifestyle do. Interventional techniques for their diagnosis and management do not extend much further than pericardiocentesis with appropriate laboratory investigations. They also do not provide the potential for the development and use of consumable equipment, or that of expensive drugs and, consequently, fi nancial investment into their research and development is not forthcoming. Diseases of the pericardium do, however, remain important within the discipline that we practice and TBP in particular deserves our continuous efforts and attention. It is unfortunate to acknowledge that we have not made much of an impact on this ancient foe over the last 50 odd years. Despite the World Health Organisation (WHO) declaring TB a global emergency in 1993, more than 20 years later we are not much better off. In 2013 an estimated 9 million people developed the disease and 1.5 million died from it.(1) TBP is predominantly a disease of SSA and it requires a solution from the very region which it torments.http://www.journals.ac.za/index.php/SAHJ/article/view/1672Publisher's versio

An unusual cause for a dilated right heart 33-years post-surgical repair of aortic coarctation

CITATION: Kyriakakis, C. G., et al. 2018. An unusual cause for a dilated right heart 33-years post-surgical repair of aortic coarctation. SA Heart, 15(3):220-224, doi:10.24170/15-3-3193.The original publication is available at https://www.journals.ac.za/index.php/SAHJPrior to planning for the surgical correction of a congenital cardiac defect it is of the utmost importance that additional defects, which themselves might also require surgical correction, be sought and identified. Of these, those leading to volume overload of the right heart, and particularly those that are not easily identified on transthoracic echocardiography, may go unnoticed during initial evaluation in childhood. We describe the approach to such a clinical problem, highlighting the value of multimodality imaging in this context, and outline the options available for surgical correction.https://www.journals.ac.za/index.php/SAHJ/article/view/3193Publisher's versio