Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2020; 12(9): 460-467
Published online Sep 26, 2020. doi: 10.4330/wjc.v12.i9.460
Pericardial effusion with tamponade – an uncommon presentation leading to the diagnosis of eosinophilic granulomatosis polyangiitis: A case report
Loba Alam, Glenmore Lasam, Robert Fishberg
Loba Alam, Department of Medicine, Atlantic Health System-Overlook Medical Center, Summit, NJ 07901, United States
Glenmore Lasam, Department of Cardiology, Icahn School of Medicine, Mount Sinai Heart at Mount Sinai Morningside, New York, NY 10025, United States
Robert Fishberg, Department of Cardiology, Atlantic Health System Overlook, Summit, NJ 07901, United States
Author contributions: Alam L and Lasam G contributed to conception and design of the study, and acquisition of the data; Fishberg R was involved in analysis and interpretation of data and contributed to drafting and revising the article.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Loba Alam, MD, Doctor, Department of Medicine, Atlantic Health System-Overlook Medical Center, 99 Beauvoir Avenue, Summit, NJ 07901, United States.
Received: June 6, 2020
Peer-review started: July 2, 2020
First decision: June 20, 2020
Revised: July 2, 2020
Accepted: September 1, 2020
Article in press: September 1, 2020
Published online: September 26, 2020
Core Tip

Core Tip: (1) To be able to investigate the etiology of pericardial effusion and cardiac tamponade with eosinophilia which is rarely caused by eosinophilic granulomatosis polyangiitis (EGPA); (2) To be mindful that anti-neutrophil cytoplasmic antibody is negative in EGPA with cardiac involvement rather than pulmonary or renal involvement; (3) To be aware that when isolated pericardial involvement leading to cardiac tamponade occurs, diagnosis is recognized by performing pericardial biopsy demonstrating histopathologic evidence of eosinophilic infiltration; (4) To consider early diagnosis of EGPA with cardiac involvement is crucial because it carries a major burden of morbidity and mortality; (5) To initiate early treatment with corticosteroids when an isolated pericardial involvement is present whereas immunosuppressants are utilized with multiorgan involvement; and (6) To conduct close surveillance in the outpatient setting to monitor the response to treatment and maintenance medications such as steroids and monoclonal antibodies.