A Case of Impending Cardiac Tamponade Caused by Effusive Constrictive Pericarditis

Catalina Sanchez-Alvarez,Oludamilola Oluleye,Monia Werlang,Mohamad H Yamani

doi:10.26502/acmcr.96550038

Catalina Sanchez-Alvarez, Oludamilola Oluleye + Show 2 more

Open Access

https://doi.org/10.26502/acmcr.96550038

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Abstract

Pericarditis is the most common pericardial disease worldwide, and can be recurrent in one third of the patients with viral and idiopathic pericarditis [1]. The diagnosis of pericarditis should be based on clinical criteria, history, clinical findings, electrocardiographic (ECG) changes and evidence of a pericardial effusion [2]. Elevation of the inflammatory markers and evidence of pericardial inflammation by an imaging technique such as contrast enhancement on the pericardium-CT scan or pericardial edema and pericardial late gadolinium enhancement on cardiac magnetic resonance imaging (MRI) are additional supportive criteria in the diagnosis [1].

Highlights

A 33 year old man, with history of recurrent pericarditis, presented with a new episode of chest pain, associated with EKG changes suggestive of pericarditis (Figure 1)
A follow up transthoracic echocardiography (TTE) evidenced resolution of the pericardial effusion, and diffuse thickening of the pericardium, with persistence of a mild respiratory variation in the left ventricle (LV) and right ventricle (RV) filling concerning for pericardial constriction (Figure 7)
The multimodal integration of different imaging techniques is needed in certain cases [3, 4]

Summary

Introduction

A 33 year old man, with history of recurrent pericarditis, presented with a new episode of chest pain, associated with EKG changes suggestive of pericarditis (Figure 1). A cardiac MRI showed normal thickness of the pericardium with trace effusion (Figure 2). There was no delayed gadolinium enhancement of the pericardium. Chest X-ray showed enlargement of the cardiac silhouette (Figure 3).

Results

Conclusion