Crohn's pericarditis identified with point-of-care ultrasonography: A case report

Area of Science:

• Cardiology
• Gastroenterology
• Medical Imaging

Background:

• Inflammatory bowel disease (IBD), specifically Crohn's disease, can present with extraintestinal manifestations affecting various organs.
• Cardiac involvement, though rare, is a significant complication of Crohn's disease, impacting patient morbidity and mortality.
• Traditional diagnostic approaches for cardiac complications in IBD may be limited, necessitating advanced imaging techniques.

Observation:

• A 71-year-old male with Crohn's disease presented with shortness of breath and chest pain, symptoms suggestive of cardiac compromise.
• Physical examination and subsequent investigations revealed pericarditis, a condition affecting the sac around the heart.
• Point-of-care ultrasonography (POCUS) was utilized, employing an alternative cardiac ultrasound window for imaging.

Findings:

• The POCUS examination successfully identified features consistent with Crohn's pericarditis, enabling a timely diagnosis.
• This case underscores the diagnostic utility of ultrasonography beyond its typical gastrointestinal applications in IBD.
• The findings highlight the importance of considering cardiac involvement in IBD patients presenting with cardiopulmonary symptoms.

Implications:

• Ultrasonography, particularly POCUS, can be a valuable tool for diagnosing cardiac manifestations of IBD when integrated into a comprehensive physical examination.
• Awareness of potential cardiac involvement and the versatility of ultrasonography can improve diagnostic accuracy and patient outcomes in Crohn's disease.
• This case advocates for a broader application of whole-body ultrasonography in managing complex IBD cases with potential systemic involvement.