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. 2023 Nov 8:28:102088.
doi: 10.1016/j.jaccas.2023.102088. eCollection 2023 Dec 20.

Not So Transient Effusive-Constrictive Pericarditis

Muhammad Majid  1   2 , Zachary S Yaker  1 , Chad Brands  2 , Shinya Unai  3 , Allan L Klein  1
Affiliations

Not So Transient Effusive-Constrictive Pericarditis

Muhammad Majid et al. JACC Case Rep. .

Abstract

A 63-year-old male patient presented with chest pain and signs of volume overload. His work-up revealed a diagnosis of transient effusive constrictive pericarditis of idiopathic etiology. Despite treatment with optimal medical therapy, he continued to experience persistent symptoms eventually requiring radical pericardiectomy.

Keywords: cardiac magnetic resonance; chest pain; constrictive; echocardiography; orthopnea; pericardial effusion; peripheral edema.

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Conflict of interest statement

Dr Klein has received research funding from Kiniksa Pharmaceuticals, Ltd and Cardiol Therapeutics; and has served on scientific advisory boards for Kiniksa Pharmaceuticals, Ltd, Swedish Orphan Biovitrum AB, Cardiol Therapeutics, and Pfizer, Inc. All other authors have reported no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Imaging and Gross Surgical Findings Demonstrating Transient Effusive Constrictive Pericarditis (A) Transthoracic echocardiography demonstrating respiratory variation across (a) the mitral valve (MV) and (b) the tricuspid valve (TV). (c, d) Tissue Doppler imaging revealing annulus reversus with medial e′ of 10 cm/s and lateral e′ of 9 cm/s. (B) Cardiac magnetic resonance demonstrating (a) moderate circumferential pericardial late gadolinium enhancement and (b) pericardial edema on T2 STIR. There was a mild interval decrease on (c) late gadolinium enhancement and (d) T2 STIR imaging in the subsequent cardiac magnetic resonance. (e, f) Free-breathing sequences demonstrating respiratory variation. (C) Radical pericardiectomy showing (a) thick pericardium tacked on both sides, (b) removed parietal pericardium, (c) before removal of the visceral layer, (d) Waffle procedure, and (e) after removal of the visceral layer. e′ = early diastolic mitral annular velocity; STIR = short tau inversion recovery; TDI = tissue Doppler velocity.
See this image and copyright information in PMC

References

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