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The follow electronic only articles are published in conjunction with this issue of Heart.

Cardiac actinomycosis in a patient presenting with acute cardiac tamponade and a mass mimicking pericardial tumour

L Jánoskuti, M Lengyel, T Fenyvesi

A case of pericardial actinomycosis mimicking a pericardial tumour is reported. After the appearance of non-specific subpleural pulmonary nodules, a 48 year old woman presented with fever and clinical signs of pericardial tamponade. Subxiphoid pericardiotomy yielded a culture negative fluid and inflammatory reactive histopathology in the pericardial biopsy specimen. Because of suspected infection cefamandole was administered for 10 days and the patient became afebrile. The pericardial effusion recurred with no clinical signs two weeks later. Steroid medication resulted in rapid regression of the pericardial effusion. Subsequent echocardiography controls showed a tumour-like pericardial mass, confirmed by cardiac magnetic imaging. Surgical exploration led to the final histological diagnosis of actinomycosis. After high dose and long term penicillin G treatment the patient recovered fully with no recurrence during two years’ follow up.

(Heart 2004;90:e27)

Knotting of a pulmonary artery catheter in the superior vena cava: surgical removal and a word of caution

G P Georghiou, B A Vidne, E Raanani

A case of postoperative pulmonary artery catheterisation complicated by knotting of the catheter (Swan-Ganz) within the superior vena cava is described. The catheter was cut off at the skin entry site. The remainder, together with the knot, was pulled out through a purse string incision in the superior vena cava.

(Heart 2004;90:e28)

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