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A Case of Effusive Constrictive Pericarditis

2005; Lippincott Williams & Wilkins; Volume: 112; Issue: 10 Linguagem: Inglês

10.1161/circulationaha.104.517557

1524-4539

Jeffrey S. Kunz, James M. King, Joseph Miller,

Cardiac tumors and thrombi

HomeCirculationVol. 112, No. 10A Case of Effusive Constrictive Pericarditis Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplementary MaterialsFree AccessReview ArticlePDF/EPUBA Case of Effusive Constrictive Pericarditis Jeffrey S. Kunz, MD, James King, MD and Joseph Miller, MD Jeffrey S. KunzJeffrey S. Kunz From the Departments of Medicine (J.S.K.), Cardiology (J.K.), and Anesthesia (J.M.), Madigan Army Medical Center, Tacoma, Wash. , James KingJames King From the Departments of Medicine (J.S.K.), Cardiology (J.K.), and Anesthesia (J.M.), Madigan Army Medical Center, Tacoma, Wash. and Joseph MillerJoseph Miller From the Departments of Medicine (J.S.K.), Cardiology (J.K.), and Anesthesia (J.M.), Madigan Army Medical Center, Tacoma, Wash. Originally published6 Sep 2005https://doi.org/10.1161/CIRCULATIONAHA.104.517557Circulation. 2005;112:e133–e134A 42-year-old male soldier in the Air National Guard presented to our hospital with a 2-month history of increasing dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, and lower extremity edema, and presented to our hospital. Complete blood count, chemistries, liver-associated enzymes, and troponin were unremarkable. Electrocardiography showed only the presence of diffuse low voltages. Echocardiography revealed a large pericardial effusion with early tamponade, which was drained by pericardiocentesis. The patient returned 2 months later with worsening dyspnea, and a repeat echocardiogram revealed a moderate loculated pericardial effusion with a diastolic "bounce" of the ventricular septum (Data Supplement Movie I). A chest MRI revealed 6-mm pericardial thickening (Figure, B). He underwent cardiac catheterization, revealing diastolic equalization of left and right heart pressures and "dip-and-plateau" diastolic ventricular pressures supporting the diagnosis of effusive constrictive pericarditis (Figure, C). The patient underwent pericardial stripping starting with the left ventricular visceral pericardium, which resulted in marked immediate hemodynamic improvement (Data Supplement Movie II). Download figureDownload PowerPointFigure 1. Moderate loculated pericardial effusion with diastolic "bounce" of ventricular septum.The online-only Data Supplement, which contains Movies I and II, is available at http://circ.ahajournals.org/cgi/content/full/112/10/e133/DC1.FootnotesCorrespondence to Jeffrey S. Kunz, MD, Dept of Medicine, Madigan Army Medical Center, Tacoma, WA 98431. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Syed F, Ntsekhe M, Mayosi B and Oh J (2012) Effusive-constrictive pericarditis, Heart Failure Reviews, 10.1007/s10741-012-9308-0, 18:3, (277-287), Online publication date: 1-May-2013. Sparano D, Kohli P and Gulati M (2010) A 63-Year-Old Woman with a Pericardial Effusion, Bilateral Pleural Effusions, and Ascites: Is the Whole Greater than the Sum of Its Parts?, Echocardiography, 10.1111/j.1540-8175.2009.01110.x, 27:4, (454-459), Online publication date: 1-Apr-2010. Grmec Š, Strnad M and Podgoršek D (2009) Comparison of the characteristics and outcome among patients suffering from out-of-hospital primary cardiac arrest and drowning victims in cardiac arrest, International Journal of Emergency Medicine, 10.1007/s12245-009-0084-0, 2:1, (7-12), Online publication date: 1-Apr-2009. Zagol B, Minderman D, Munir A and D'Cruz I (2007) Effusive Constrictive Pericarditis: 2D, 3D Echocardiography and MRI Imaging, Echocardiography, 10.1111/j.1540-8175.2007.00505.x, 24:10, (1110-1114), Online publication date: 1-Nov-2007. September 6, 2005Vol 112, Issue 10 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.104.517557PMID: 16145008 Originally publishedSeptember 6, 2005 PDF download Advertisement SubjectsCardiovascular SurgeryEchocardiographyHeart FailureImaging