Abstract
A case report of subacute effusive-constrictive pericarditis in a patient with iatrogenic hemopericardium is presented. A 69-year-old man was referred to our department for percutaneous coronary intervention complicated with hemopericardium with cardiac tamponade. Continuous bleeding after pericardiocentesis required an urgent surgical revision with evacuation of hemopericardium and local treatment of the sources of bleeding. A mild to moderate pericardial effusion persisted in the post-operative period, without any symptoms of cardiac tamponade. A global heart failure developed in the patient eleven months after complicated coronary intervention (surgical revision). A technically successful pericardiocentesis did not improve the clinical state of the patient. Echocardiography and magnetic resonance imaging confirmed the diagnosis of effusive-constrictive pericarditis. Subsequent pericardiectomy resulted in a prompt and complete relief of symptoms and signs of heart failure. Effusive-constrictive pericarditis is an uncommon disorder characterised by symptoms of refractory cardiac failure, thickening of the visceral pericardium and pericardial effusion, with no improvement after pericardiocentesis. In indicated cases, pericadiectomy leads to recovery in a large percentage of patients.
Highlights
Effusive-constrictive pericarditis is an uncommon disorder characterised by thickening of the visceral pericardium and the presence of tense pericardial effusion
The onset of the disorder was related to hemopericardium, which was a primary complication of a percutaneous coronary intervention (PCI) and which persisted in the form of haemorrhagic pericardial effusion even after urgent surgical revision
We present a case report of effusive-constrictive pericarditis in a 69-year-old man
Summary
Effusive-constrictive pericarditis is an uncommon disorder characterised by thickening of the visceral pericardium and the presence of tense pericardial effusion. The syndrome can occur in various types of pericarditis with effusion but is relatively more frequent as a result of tuberculosis, neoplasia or after chest radiation. Cardiac surgery is a rare cause of effusive-constrictive pericarditis. The onset of the disorder was related to hemopericardium, which was a primary complication of a percutaneous coronary intervention (PCI) and which persisted in the form of haemorrhagic pericardial effusion even after urgent surgical revision. The options for diagnostics and therapy of effusive-constrictive pericarditis are discussed.
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