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Case Reports
. 2024 Jun 29;16(6):e63454.
doi: 10.7759/cureus.63454. eCollection 2024 Jun.

The Utility of Invasive Hemodynamic Assessment in Diagnosing Constrictive Pericarditis: A Case Report

Fawaz Mohammed  1 , Sajjad Haider  2   3 , Jacqueline Dawson Dowe  2 , Muhammad Akbar  2 , Mohammad Abdul-Waheed  2
Affiliations
Case Reports

The Utility of Invasive Hemodynamic Assessment in Diagnosing Constrictive Pericarditis: A Case Report

Fawaz Mohammed et al. Cureus. .

Abstract

Pericarditis leading to constrictive physiology is rarely diagnosed given its vague presentation. Abnormal diastolic filling from a stiff pericardium brings about signs and symptoms consistent with right-sided heart failure. We report the case of a 57-year-old female who presented with worsening shortness of breath and signs of volume overload. Chest computed tomography showed evidence of pericardial calcifications with pericardial effusion. Further evaluation with right heart catheterization suggested findings diagnostic of constrictive pericarditis.

Keywords: constrictive physiology; fluoroscopy; pericardial effusion; right heart catheterization; viral pericarditis.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Electrocardiogram findings
Electrocardiogram showing normal sinus rhythm with less than 5 mm QRS complexes vertically in limb leads (I, II, III, aVR, aVL, and aVF) meeting low voltage criteria. Also demonstrating non-specific ST-T wave changes in the anterolateral leads (green arrows).
Figure 2
Figure 2. Chest computed tomography
Chest computed tomography demonstrating pericardial effusion (asterisk) and pericardial calcifications (arrows).
Figure 3
Figure 3. View of the pericardium with fluoroscopy
Fluoroscopy showing eggshell calcifications of the pericardium (arrows).
Figure 4
Figure 4. Right heart catheterization findings
Right heart catheterization with simultaneous left ventricular and right ventricular pressure tracing showing discordant pressure change during inspiration (arrows), square root sign (red circle).
See this image and copyright information in PMC

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