Constrictive Pericarditis Masked by CAPD

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I ardiac disease is the leading cause of death in the end-stage renal disease population. ericardial diseases, although less common than ther types of cardiac disease, continue to contribte to the increased cardiovascular morbidity and ortality in this population. Dialysis pericarditis s a term used to describe the occurrence of linical features of pericardial disease after clinial stabilization on long-term dialysis therapy usually 8 weeks after its initiation). Most bservational data suggest inadequate dialysis is he major factor in its development. Patients with constrictive pericarditis typically resent with signs of systemic venous congesion, including hepatomegaly, ascites, and periphral edema. Deep “x” and “y” descent in the ugular venous pulse and Kussmaul sign (jugular enous pressure does not decrease appropriately uring inspiration or even increases) may also be resent. With more prolonged and severe constricive pericarditis, symptoms related to decreased ardiac output may occur, including dyspnea, ypotension, dizziness, fatigue, cachexia, and eight loss. In this report, we describe a long-term dialysis atient who developed refractory hypotension elated to constrictive pericarditis with extensive ericardial calcification. Many of the classic hysical findings associated with constrictive ericarditis were absent or masked by ongoing olume removal by means of continuous ambulaory peritoneal dialysis (CAPD). We discuss