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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Related Experiment Video

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Translational Rabbit Model of Chronic Cardiac Pacing
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An atypical pacemaker pocket hematoma containing chyliform fluid.

Stefano Maffè1, Paola Paffoni1, Luca Bergamasco1

  • 1Division of Cardiology, SS Trinita' Borgomanero Hospital, ASL NO, Novara, Italy.

Indian Pacing and Electrophysiology Journal
|April 4, 2022
PubMed
Summary

Subcutaneous hematoma after cardiac device implantation can lead to rare pseudochyle fluid accumulation. This case highlights cholesterol-rich fluid formation in an implantable cardioverter-defibrillator pocket.

Keywords:
Implantable cardioverter defibrillatorPocket hematomaPseudochylous

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Area of Science:

  • Cardiology
  • Medical Complications
  • Fluid Dynamics

Background:

  • Subcutaneous hematoma is a known complication of cardiac device implantation.
  • Accumulation of chyliform material in device pockets is exceptionally rare.

Observation:

  • A 60-year-old male with antiphospholipid antibody syndrome and rheumatoid arthritis developed a subcutaneous hematoma post-ICD implantation.
  • Seven months later, a large, asymptomatic swelling reappeared in the ICD pocket, yielding 100ml of gold-colored, odorless fluid upon drainage.

Findings:

  • Chemical analysis revealed high cholesterol (704 mg/dl) and low triglycerides (80 mg/dl) in the drained fluid, consistent with pseudochyle fluid.
  • Microscopic and cytologic examination showed macrophages laden with cholesterol, supporting degradation of a chronic hematoma.

Implications:

  • This case presents extremely rare documentation of pseudochyle fluid formation within an implantable cardioverter-defibrillator pocket.
  • It underscores the importance of considering chronic hematoma degradation as a cause of unusual fluid collections in implanted device sites.