Chronic Cardiac Herniation: A Peculiar Diagnosis

Area of Science:

• Cardiology
• Thoracic Surgery
• Rheumatology

Background:

• Adult-onset Still's disease (AOSD) is a rare systemic inflammatory condition.
• Polyserositis is a known complication of AOSD, potentially requiring surgical intervention.
• Complications such as thromboembolism can occur in AOSD patients, necessitating anticoagulation therapy.

Observation:

• A 56-year-old male with AOSD developed cardiac herniation following pleurectomy and pericardiectomy.
• Progressive dyspnea and echocardiogram findings suggested constrictive pericarditis.
• Cardiac magnetic resonance imaging confirmed cardiac herniation, a rare post-surgical complication.

Findings:

• Surgical pericardiectomy successfully corrected the cardiac herniation.
• The patient experienced complete resolution of anatomical abnormalities post-surgery.
• Persistent exertional dyspnea was noted post-discharge, warranting further monitoring.

Implications:

• Cardiac herniation is a rare but serious complication that can occur after thoracic surgery.
• Accurate diagnosis relies on advanced imaging techniques like CT and CMR.
• Interdisciplinary collaboration is essential for managing complex cases of cardiac herniation.