Work

Noncardiac Procedural Complication Resulting in Pericarditis

Year: 2025

Type: article

Abstract: BACKGROUND: Endoscopic cyanoacrylate injection (ECI) is a standard management for bleeding gastric varices. There have been no previous cases of pericarditis secondary to ECI into the pericardium. CASE SUMMARY: A 55-year-old woman with bleeding gastric varices secondary to pancreatic neuroendocrine tumor with splenic vein involvement underwent ECI, which resulted in postprocedural pericarditis secondary to direct injection into the pericardial space. DISCUSSION: Management of this foreign substance-induced pericarditis is outside the realm of current guidelines. Based on the known inflammatory and insoluble nature of cyanoacrylate, standard anti-inflammatory therapies were implemented. Despite prolonged anti-inflammatory therapy, this patient continues to have symptomatic pericarditis as well as inflammatory changes on cardiac imaging months after her procedure. TAKE-HOME MESSAGES: Postprocedural pericarditis from ECI is an infrequent yet serious complication. It is imperative to monitor serial inflammatory markers and cardiac imaging, as well as to monitor symptom resolution, to assess the need for prolonged anti-inflammatory tapers or pericardiectomy.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105338

Authors: Grace Hagan, Teodora Donisan, Hayan Jouni, Sushil A. Luis

Institution: Mayo Clinic

Language: English

Topic: Pericarditis and Cardiac Tamponade

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850