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. 2013:2013:957497.
doi: 10.1155/2013/957497. Epub 2013 Sep 24.

Chronic constrictive pericarditis

Hossein Doustkami  1 , Afshin Hooshyar  2 , Nasrollah Maleki  2 , Zahra Tavosi  3 , Iraj Feizi  4
Affiliations

Chronic constrictive pericarditis

Hossein Doustkami et al. Case Rep Cardiol. 2013.

Abstract

Constrictive pericarditis (CP) is a rare clinical entity that can pose diagnostic problems. The diagnosis of CP requires a high degree of clinical suspicion. The gold standard for diagnosis is cardiac catheterization with analysis of intracavitary pressure curves, which are high and, in end diastole, equal in all chambers. We present a patient with unexplained dyspnea, recurrent right-side pleural effusion, and ascites. Analysis of the ascitic fluid revealed a high protein content and an elevated serum-ascites gradient. Echocardiography, computed tomography, and cardiac catheterization revealed the diagnosis of CP. He underwent complete pericardiectomy and to date has made a good recovery. The diagnosis of CP is often neglected by admitting physicians, who usually attribute the symptoms to another disease process. This case exemplifies the difficulty in diagnosing this condition, as well as the investigation required, and provides a discussion of the benefit and outcomes of prompt treatment.

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Figures

Figure 1
Figure 1
Chest CT showing pleural effusion, cardiac calcification, ascites, and IVC dilation.
Figure 2
Figure 2
Echocardiography showing septal bouncing (a), dilation of IVC (b), pericardial effusion, and calcification (c).
Figure 3
Figure 3
The equalization of diastolic pressures and “square root sign” or “dip and plateau sign” of the left ventricular waveforms.
Figure 4
Figure 4
Surgical and pathological findings.
See this image and copyright information in PMC

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