Pericardioscopy and epicardial biopsy--new diagnostic tools in pericardial and perimyocardial disease

Area of Science:

• Cardiology
• Diagnostic Imaging
• Pathology

Background:

• Pericardial effusion due to inflammatory perimyocardial disease requires accurate diagnosis.
• Traditional diagnostic methods may not always provide definitive etiological classification.

Purpose of the Study:

• To evaluate pericardioscopy as a diagnostic tool for visualizing epicardial and pericardial alterations.
• To determine the etiological causes of pericardial effusion in patients with inflammatory perimyocardial disease.

Main Methods:

• Pericardioscopy was performed in 35 patients with pericardial effusion.
• Fluid was aspirated and exchanged; pericardial pressures were measured.
• Flexible or rigid endoscopes were used for visualization, with biopsies for cytology and histology.

Main Results:

• Pericardioscopy enabled macroscopic visualization of the epicardium and pericardium.
• Specific diagnoses included viral pericarditis (n=7), lymphocytic perimyocarditis (n=16), bacterial pericarditis (n=7), and autoimmune pericarditis (n=5).
• Viral diagnoses were confirmed by in situ hybridization for cytomegalovirus or enterovirus/coxsackievirus B4 isolation.

Conclusions:

• Pericardioscopy is an effective diagnostic tool for inflammatory perimyocardial diseases.
• It facilitates direct visualization and targeted biopsies for etiological classification of pericarditis.
• The study successfully identified various causes of pericardial effusion, aiding in diagnosis and management.