Case Of Constrictive Pericarditis Research Articles

A case of constrictive pericarditis after COVID-19 vaccine

It is known that mRNA vaccines against COVID-19 infection are effective in reducing symptoms, mortality and hospitalization of the patients suffering from COVID-19. In fact, these can cause some complications, as fever, headache, dizziness and, rarely, can induce some cardiac involvement, such as the inflammatory reaction of myocardium and/or pericardium. We describe a case of young healthy male-subject who received a second dose of Spikevax vaccine. Two days from the vaccine inoculation, he developed an acute inflammation of the pericardial leaflets, responsible for constrictive pericarditis. The clinical suspect was confirmed by instrumental and laboratory data. But, after the anti-inflammatory drugs administration, he completely recovered. Learning objective: This case report describes the occurrence of constrictive pericarditis following the vaccination against COVID-19. The most common instrumental and laboratory texts, useful for the diagnosis, are illustrate. The therapeutic treatment are reported. The pathogenetic mechanisms are hypothesized.

Degos disease complicated by constrictive pericarditis in remote phase: a case report

BackgroundDegos disease, also known as malignant atrophic papulosis, is characterised by cutaneous manifestations due to chronic thrombo-obliterative vasculopathy. There have been reports of the rare late-onset Degos disease complicated by constrictive pericarditis (CP). This study reports a case of CP caused by Degos disease that developed 20 years after diagnosis.Case presentationA 62-year-old woman who had been taking aspirin for 20 years for Degos disease was hospitalised for worsening of heart failure. The patient was diagnosed with CP and underwent pericardiectomy. Pathological findings suggested the involvement of Degos disease. The postoperative course was uneventful, and her heart failure and Degos disease did not worsen.ConclusionsThe study findings suggests that Degos disease can cause long-term CP. Aspirin effectively inhibited the progression of Degos disease, and surgical treatment was necessary when heart failure due to CP was refractory to treatment.

Immunoglobulin G4-related constrictive pericarditis and the importance of a thorough workup: a case report

BackgroundConstrictive pericarditis remains a problematic diagnosis and a thorough investigation is critical. Among possible aetiologies, immunoglobulin-G4 (IgG4)-related pericardial disease is an unusual cause of pericardial constriction. We report a challenging diagnostic case of pericardial constriction due to IgG4-related disease.Case presentationA 68-year old male with a history of inferior myocardial infarction with right ventricle (RV) involvement was thrice-hospitalized due to marked ascites and peripheral oedema. Systemic congestion was initially attributed to RV dysfunction due to previous infarction. Yet, at the final admission, a re-assessment echocardiogram followed by cardiac computed tomography, magnetic resonance and right heart catheterization raised a possible diagnosis of constrictive pericarditis with a finding of abnormal pulmonary venous return. Patient therefore underwent pericardiectomy and surgical correction of pulmonary venous return. Pericardium histology revealed an IgG4-related pericardial constriction. Patient was later discharged on corticosteroids with marked symptomatic improvement.ConclusionIgG4-related disease remains a rare cause of pericardium constriction while also presenting a challenging diagnosis in everyday clinical practice. This case exemplifies the difficulties faced by clinicians when reviewing a possible case of constrictive pericarditis, while highlighting the importance of a multimodality assessment.

Constrictive Pericarditis with Cardiac Ascites Caused Spontaneous Bacterial Peritonitis

Patients with constrictive pericarditis (CP) typically present with symptoms related to right-sided heart failure, such as cardiac ascites. Spontaneous bacterial peritonitis (SBP) usually arises in association with ascites secondary to hepatic cirrhosis. We herein report a rare case of CP in which SBP developed due to cardiac ascites, even in the absence of cirrhosis. In this case, pericardiectomy improved both the hemodynamics and the ascites, while therapy with diuretics alone was insufficient. It is important to consider SBP in the differential diagnosis when any abdominal symptoms or an inflammatory response is found in patients with heart failure and cardiac ascites.

A case of constrictive pericarditis, complicated with systemic sclerosis

A case of constrictive pericarditis, complicated with systemic sclerosis

A Case of Constrictive Pericarditis after Minimally Invasive Mitral Valve Surgery Requiring Pericardiectomy

症例は68歳，男性．僧帽弁狭窄症，三尖弁閉鎖不全症，心房細動に対し僧帽弁置換術，三尖弁形成術，MAZE手術を内視鏡下右小開胸で施行した．特記すべき合併症なく第7病日に退院となったが，退院後約2カ月が経過した頃より心嚢水貯留と右心不全症状を認め，利尿剤やステロイドなど内服加療を行ったがコントロール困難で入院を繰り返した．CT検査や心臓超音波検査では特異的な所見は認めなかったが，心臓カテーテル検査でdip and plateau patternを認めたため収縮性心膜炎と診断し，胸骨正中切開で心膜切除術を施行した．心膜は皮革状の肥厚を認め，心外膜に強固に癒着していた．心膜切除により，術中から中心静脈圧の低下に加え肉眼的にも右室収縮の改善を認めた．術後1年現在経過良好である．心臓手術後の収縮性心膜炎は稀な合併症であるが，特に低侵襲手術後の収縮性心膜炎の報告は過去になかったため，文献的考察を加えて報告する．

Constrictive pericarditis in a patient with inherited factor VII deficiency

Constrictive pericarditis (CP) is the final stage of a chronic inflammatory process characterized by fibrous thickening and calcification of the pericardium that impairs diastolic filling, reduces cardiac output, and ultimately leads to heart failure. We present a clinical case of CP in a patient with rare inherited bleeding disorder - factor VII deficiency. Heart failure due to CP was suspected based on clinical symptoms, results of ultrasonic and radiological investigations. The diagnosis was verified by the results of cardiac magnetic resonance imaging. Pericardectomy was performed resulting in significant improvement in the patient's condition.

An Unusual Case of Constrictive Pericarditis in a Young Patient With Childhood History of Successfully Treated Kawasaki Disease

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is a disease in which blood vessels in the body become inflamed. It occurs usually in childhood and one of the well-known cardiac complications is coronary artery aneurysm which occurs usually after 1 - 2 years. Constrictive pericarditis is not a known sequela of Kawasaki disease. We present a case of a 21-year-old white male referred to the emergency department by his gastroenterologist after an outpatient abdominal ultrasound obtained for elevated liver enzymes revealed ascites and bilateral pleural effusion. He has background history of Kawasaki disease at the age of 8 years that was treated with aspirin and intravenous immunoglobulin (IVIG) without any cardiac complications based on echocardiogram obtained after treatment. Autoimmune screen was negative. He had echocardiogram which revealed evidence of constrictive pericarditis. J Med Cases. 2018;9(7):211-214 doi: https://doi.org/10.14740/jmc3071w

Constrictive pericarditis – A challenging diagnosis

Constrictive pericarditis is a challenging diagnosis. This case report describes a patient with constrictive pericarditis (CP) secondary to radiation therapy. As the patient presented with non-specific symptoms, various modalities (both invasive and non-invasive) were used in the diagnosis and differentiation of CP from restrictive cardiomyopathy (RCM). This case of surgicallyproven CP demonstrates that a high clinical suspicion based on physical findings should be combined with multiple diagnostic modalities in the diagnosis of CP. It is crucial to differentiate CP from RCM due to the significant variance in treatment.

Hypertrophic Cardiomyopathy and Tricuspid Regurgitation with Right Heart Failure Mimicking Constrictive Pericarditis: A Rare Case Report

Cardiomyopathy is the measurable deterioration of the function of the myocardium for any reason, usually leading to heart failure. Tricuspid regurgitation may result from structural alterations of any one or all of the components of the tricuspid valve apparatus which include the leaflets, chordae tendinae, annulus, and papillary muscles or adjacent right ventricular muscle. We are reporting a case of Cardiomyopathy with tricuspid regurgitation with right heart failure in a 38 years male. Preoperatively he was diagnosed as a case of constrictive pericarditis. Diagnosis of Tricuspid regurgitation with cardiomegaly was confirmed peroperatively. During operatrion tricuspid valve anatomy dimunited and severe tricuspid regurgitation was identified. Grossly dilated RA, RV identified and other anatomy of heart was normal. De-Vega Tricuspid anuloplasty done with pledgeted stich 2-0 polyster. Part of right atrial wall (2X2.5 inch) excised and resected portion sent for histopathology. Postoperative course was uneventful with marked improvement of symptoms.University Heart Journal Vol. 11, No. 1, January 2015; 45-47

Constrictive Pericarditis in a Post Cardiac Transplant Patient

Constrictive pericarditis (CP) is a rare but significant complication in the post cardiac transplant patient and clinically presents as progressive heart failure. CP is defined as an inflammatory condition in which the heart is encased in a rigid non-pliable pericardium resulting in restricted diastolic filling. Generally, the risk factors associated with developing this include pericardial effusion post transplant, infections and acute rejection. Here we describe a case of CP in a post cardiac transplant patient without obvious risk factors.

Constrictive Pericarditis in the Presence of Remaining Remnants of a Left Ventricular Assist Device in a Heart Transplanted Patient.

Constrictive pericarditis (CP) is a severe subform of pericarditis with various causes and clinical findings. Here, we present the unique case of CP in the presence of remaining remnants of a left ventricular assist device (LVAD) in a heart transplanted patient. A 63-year-old man presented at the Heidelberg Heart Center outpatient clinic with progressive dyspnea, fatigue, and loss of physical capacity. Heart transplantation (HTX) was performed at another heart center four years ago and postoperative clinical course was unremarkable so far. Pharmacological cardiac magnetic resonance imaging (MRI) stress test was performed to exclude coronary ischemia. The test was negative but, accidentally, a foreign body located in the epicardial adipose tissue was found. The foreign body was identified as the inflow pump connection of an LVAD which was left behind after HTX. Echocardiography and cardiac catheterization confirmed the diagnosis of CP. Surgical removal was performed and the epicardial tubular structure with a diameter of 30 mm was carefully removed accompanied by pericardiectomy. No postoperative complications occurred and the patient recovered uneventfully with a rapid improvement of symptoms. On follow-up 3 and 6 months later, the patient reported about a stable clinical course with improved physical capacity and absence of dyspnea.

Monitoring of the jugular venous pressure response to diuretics in constrictive pericarditis

When the jugular venous pressure (JVP) is markedly raised in patients with suspected right-sided heart failure [ [1] Grabysa R. Widawski T. Przelaskowski P. Don't blindly trust in BNP concentration: a case of constrictive pericarditis. Int. J. Cardiol. 2015; 180: 50-51 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar ], the diagnostic potential of this parameter should be optimised by monitoring its response to diuretics [ [2] Conti C.R. Friesinger G.C. Chronic constrictive pericarditis clinical and laboratory findings in 11 cases. Johns Hopkins Med. J. 1967; 120: 262-274 PubMed Google Scholar ], given the fact that monitoring might raise the index of suspicion for constrictive pericarditis (CP) as the alternative diagnosis. In a series of 11 patients with CP (including nine with unequivocal elevation of JVP), despite rest and diuresis, “the jugular veins remained distended and the pressure elevated in all instances of constrictive pericarditis” [ [2] Conti C.R. Friesinger G.C. Chronic constrictive pericarditis clinical and laboratory findings in 11 cases. Johns Hopkins Med. J. 1967; 120: 262-274 PubMed Google Scholar ].

Don't blindly trust in BNP concentration: A case of constrictive pericarditis

Don't blindly trust in BNP concentration: A case of constrictive pericarditis

A Case of Constrictive Pericarditis That Tolvaptan was Effective for Therapy of Heart Failure

A Case of Constrictive Pericarditis That Tolvaptan was Effective for Therapy of Heart Failure

心膜切除術が著効を示した開心術後収縮性心膜炎の1例

開心術後収縮性心膜炎は稀な疾患であり，診断に難渋することもある．また，手術法もさまざまであり（人工心肺の使用の有無，開胸方法など），術後再発の報告もある．今回，開心術後収縮性心膜炎に対し，体外循環を使用し正中切開アプローチによる心膜切除術を行い良好な結果を得たので報告する．症例は67歳男性．2005年に僧帽弁閉鎖不全症に対し僧帽弁形成術を受けた．2010年1月より易疲労感を自覚し，下腿浮腫も認め内科的加療を受けていた．2012年7月より倦怠感が増悪し，精査を施行した．心エコーでは特徴的所見がなかったが，CT・MRIで右室前面～左室全周の心膜肥厚を認めた．両心カテーテル検査では右室拡張期圧波形のdip and plateauがあり，両心室の拡張末期圧が呼気・吸気時にほぼ等しかった．以上の所見より収縮性心膜炎と診断し手術を行った．手術は再胸骨正中切開で，人工心肺を使用し心拍動下に施行した．ほぼ完全に心膜を切除した．横隔神経の損傷を避けるため，左胸膜を切開し左胸腔より直視下に横隔神経を確認し心膜を一部温存した．心外膜との強い癒着が認められた左室前壁基部は心膜を残しwaffle procedureを追加した．心係数は術前1.5 l/min/m2 から術後2.7 l/min/m2 まで改善し，中心静脈圧も術前17 mmHgから術後10 mmHgまで改善した．術後，両心カテーテル検査でdip and plateauは消失，拡張障害は改善した．開心術後収縮性心膜炎の治療には胸骨正中切開で人工心肺を使用し，可能な限り心膜を切除することが望ましい．

A case of constrictive pericarditis caused by chest blunt trauma

A case of constrictive pericarditis caused by chest blunt trauma

A Case of Constrictive Pericarditis with Ascites and Lower Extremities Varices

A Case of Constrictive Pericarditis with Ascites and Lower Extremities Varices

Constrictive pericarditis in a young patient with very thick pericardium initially diagnosed as cirrhosis

Constrictive pericarditis (CP) is a disease of pericardium that restricts filling of the heart. Patients with CP generally present to hospitals with exercise-induced dyspnea, pretibial edema and abdominal ascites, and it is sometimes mistakenly diagnosed as liver or renal disease. Pericardial thickening, which is defined as more than 4 mm in diameter, is observed in nearly 80% of patients. In the present paper, we describe a case of CP with a pericardial thickness of 12 mm that was initially diagnosed as cirrhosis.

A case of constrictive pericarditis and thoracic aortic aneurysm: A hybrid therapeutic approach

The authors describe the case of a 59-year-old man, a former smoker, with hypertension, chronic renal failure undergoing hemodialysis, and a history of stent grafting for repair of an abdominal aortic aneurysm and miliary tuberculosis, who was diagnosed with constrictive pericarditis and a thoracic aortic aneurysm. In a patient with such a complex medical history, there were several etiologies to consider. The treatment consisted of pericardiectomy and a hybrid technique of supra-aortic debranching and subsequent endovascular stent-graft repair.