胸腔鏡下心膜開窓術で診断されたｓｍａｌｌ　ｖｅｓｓｅｌ　ｖａｓｃｕｌｉｔｉｓの１例

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  • A CASE OF SMALL VESSEL VASCULITIS DIAGNOSED BY PERICARDIAL FENESTRATION UNDER THORACOSCOPY

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We report a rare case of small vessel vasculitis presented with chast pain. A 47-year-old woman complaining of discomfort in the chest was admitted to the department of cardiology in our hospital with a diagnosis of chronic heart failure. Pericardial effusion of unknown origin was diagnosed. Conservative therapy was ineffective, and she was referred to our department. Thoracoscopic pericardial fenestration and biopsy of the pericardium were performed to release cardiac tamponade as well as to determine the origin. No malignancy was observed and capillary vasculitis with lymphocyte infiltration was evident from a pathologic examination. Consequently, small vessel vasculitis was diagnosed. Neither accumulation of pericardial effusion nor cardiac failure has recurred as of one year after the operation. Thoracoscopic pericardial fenestration is useful for both diagnosis and treatment, particularly in cases in which no diagnosis is made before surgery.

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