Constrictive pericarditis

2015 ◽  
pp. 520-535
Author(s):  
Jérôme Garot ◽  
Frank Rademakers
Keyword(s):  
Differential Diagnosis ◽  
Constrictive Pericarditis ◽  
Clinical Findings ◽  
Respiratory Cycle ◽  
Atrial Pressure ◽  
Pericardial Disease ◽  
Multiple Modalities ◽  
Pericardial Syndromes ◽  
Very High ◽  
Pericardial Thickening

The diagnosis of constrictive pericarditis (CP) generally requires both the demonstration of an appropriate physiology and evidence of pericardial thickening. Differential diagnosis in pericardial disease remains difficult and challenging to the clinician. The pathophysiologic characteristics of the various pericardial syndromes can be studied with different imaging modalities, but it is crucial to register morphology, function and flow during the different phases of the respiratory cycle. When a discrepancy exists between clinical findings and hemodynamic evaluation with imaging, multiple modalities should be combined and, if a very low or very high atrial pressure is suspected, an intervention to increase or lower this pressure can be required to unmask characteristic findings during respiration with respect to ventricular interdependence.

scholarly journals Graft-versus-host disease: a case report of a rare but reversible cause of constrictive pericarditis

2020 ◽  
Vol 4 (2) ◽  
pp. 1-5
Author(s):  
Christopher A Pieri ◽  
Neil Roberts ◽  
John Gribben ◽  
Charlotte Manisty
Keyword(s):  
Constrictive Pericarditis ◽  
Hospital Admissions ◽  
High Dose Chemotherapy ◽  
Immunomodulatory Therapy ◽  
High Dose ◽  
Pericardial Disease ◽  
Host Disease ◽  
Graft Vs Host Disease ◽  
Pericardial Thickening ◽  
Small Pericardial Effusion

Abstract Background  Constrictive pericarditis (CP), although an uncommon cause of heart failure, requires specialist multidisciplinary input and multi-modality imaging to identify the underlying aetiology and treat potentially reversible causes. Case summary  We report the case of a 74-year-old gentleman referred for assessment of progressive exertional dyspnoea and peripheral oedema, 30 months following treatment of acute myeloid leukaemia with high-dose chemotherapy and allogeneic stem cell transplantation. Clinical examination and cardiac imaging revealed a small pericardial effusion and pericardial thickening with constrictive physiology; however, no aetiology was identified despite diagnostic pericardiocentesis. The patient required recurrent hospital admissions for intravenous diuresis, therefore, following multidisciplinary discussions, surgical partial pericardectomy was performed. Histology suggested graft-vs.-host disease (GvHD) and post-operatively, the patient improved clinically. Following immunomodulatory therapy with ruxolitinib for both pericardial and pulmonary GvHD, his functional status improved further with no subsequent hospital admissions. Discussion  Although pericardial disease in cancer patients is common, CP is unusual. Determining the underlying aetiology is important for subsequent management, and here, we describe the use of multi-modality imaging to diagnose a rare cause, GvHD, which responded to surgical treatment and immunomodulatory therapy.

Pericardial disease

2016 ◽  
Author(s):  
Bernard Paelinck ◽  
Aleksandar Lazarević ◽  
Pedro Gutierrez Fajardo
Keyword(s):  
Differential Diagnosis ◽  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Restrictive Cardiomyopathy ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Two Dimensional ◽  
Pericardial Disease ◽  
Pericardial Diseases

Echocardiography is the cornerstone for the diagnosis of pericardial disease. It is a portable technique allowing morphological and functional multimodality (M-mode, two-dimensional, Doppler, and tissue Doppler) imaging of pericardial disease. In addition, echocardiography is essential for differential diagnosis (pericardial effusion vs pleural effusion, constrictive pericarditis vs restrictive cardiomyopathy) and allows bedside guiding of pericardiocentesis. This chapter describes normal pericardial anatomy and reviews echocardiographic features of different pericardial diseases and their pathophysiology, including pericarditis, pericardial effusion, constrictive pericarditis, pericardial cyst, and congenital absence of pericardium.

scholarly journals Calcified pericardial band at the level of right ventricle causing midventricular obstruction: a case report of constrictive pericarditis

2012 ◽  
Vol 7 (4) ◽  
pp. 58-62
Author(s):  
MP Gautam ◽  
D Sharma ◽  
G Subramanyam ◽  
S Gautam ◽  
U Ghimire
Keyword(s):  
Constrictive Pericarditis ◽  
Young Female ◽  
Medical Sciences ◽  
Pericardial Disease ◽  
Management Journal ◽  
Antituberculous Treatment ◽  
Atrioventricular Groove ◽  
The Right ◽  
Pericardial Thickening ◽  
Midventricular Obstruction

Constrictive pericarditis is a debilitating but potentially curable disease. Diffuse pericardial thickening and calcification is a classic feature described; localized pericardial constrictions are very rare. Here we report a case of a young female who had presented with constrictive pericarditis and had localized calcific constrictive band located at the level distal to atrioventricular groove which had caused right midventricular obstruction. In many patients the cause of the pericardial disease is undetermined, and in them an asymptomatic or forgotten bout of viral or tubercular pericarditis, acute or idiopathic, may have been the inciting event. Our patient had pulmonary tuberculosis during childhood and received antituberculous treatment. Investigations revealed the presence of thickened pericardium and a thickened calcific constrictive band around the right ventricles at midventricle level causing midventricular obstruction. She was referred to another centre for further surgical management. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 58-62 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6813

An Isolated Vertebral Metastasis of Urachal Adenocarcinoma

2004 ◽  
Vol 128 (9) ◽  
pp. 1043-1045 ◽  
Author(s):  
Sophia Taylor ◽  
Patrizia Bacchini ◽  
Franco Bertoni
Keyword(s):  
Differential Diagnosis ◽  
Biopsy Specimen ◽  
Clinical Findings ◽  
Thoracic Vertebra ◽  
Partial Cystectomy ◽  
Rare Tumor ◽  
Vertebral Metastasis ◽  
Metastatic Patterns ◽  
Urachal Adenocarcinoma

Abstract We describe a case of urachal adenocarcinoma arising in a 30-year-old woman. The patient underwent partial cystectomy. Three years later, she presented with an isolated metastasis to a thoracic vertebra, which was treated by vertebral corporectomy. Histologic findings are described, and the clinical findings, management, and metastatic patterns of this rare tumor, as well as the differential diagnosis on a biopsy specimen, are discussed.

scholarly journals Genetic testing for choroideremia

2017 ◽  
Vol 1 (s1) ◽  
pp. 26-28
Author(s):  
Andi Abeshi ◽  
Alessandra Zulian ◽  
Tommaso Beccari ◽  
Munis Dundar ◽  
Francesco Viola ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Clinical Trials ◽  
Optical Coherence Tomography ◽  
Differential Diagnosis ◽  
Clinical Utility ◽  
Scientific Literature ◽  
Genetic Test ◽  
Fundus Autofluorescence ◽  
Clinical Findings ◽  
Ophthalmological Examination

Abstract We studied the scientific literature and disease guidelines in order to summarize the clinical utility of the genetic test for choroideremia (CHM). CHM is an inherited X-linked recessive disorder associated with variations in the CHM gene. The overall prevalence of CHM varies from 1 in 50 000 to 1 in 100 000. Clinical diagnosis is based on clinical findings, ophthalmological examination, visual field, fundus autofluorescence, optical coherence tomography and electroretinography. The genetic test is useful for confirming diagnosis and for differential diagnosis, couple risk assessment and access to clinical trials.

Neonatal Adenovirus Infection: Four Patients and Review of the Literature

PEDIATRICS ◽  
1991 ◽  
Vol 87 (6) ◽  
pp. 890-896
Author(s):  
Mark J. Abzug ◽  
Myron J. Levin
Keyword(s):  
Differential Diagnosis ◽  
Clinical Findings ◽  
Adenovirus Infection ◽  
Review Of The Literature ◽  
Birth Canal ◽  
Maternal Illness ◽  
Epidemiologic Evidence ◽  
Major Mode ◽  
Mode Of Transmission ◽  
Virus Isolates

Four newborns with adenovirus infection are described, and the profile of neonatal adenovirus disease is outlined based on the cases of these newborns and nine previously described. Characteristic historical features included prolonged rupture of membranes, maternal illness, vaginal delivery, and onset of illness within the first 10 days of life. Clinical findings included lethargy, fever or hypothermia, anorexia, apnea, hepatomegaly, bleeding, and progressive pneumonia. Thrombocytopenia, coagulopathy, and hepatitis were typical laboratory manifestations. Illness was severe and generally unremitting; only two survivors have been reported. Pathologic changes were prominent in lung, liver, and brain. Virus isolates, predominantly serotypes 3, 7, 21, and 30 were obtained from multiple sites and organs. Epidemiologic evidence suggests that viral acquisition from the mother, perhaps via the birth canal, is a major mode of transmission. Neonatal adenovirus infection, which is frequently disseminated and generally fatal, should be considered in the differential diagnosis of neonatal sepsis and pneumonia.

Radionuclide Pericardial Scan. Is It Outmoded by Echocardiography?

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 637-637
Author(s):  
Richard A. Meyer ◽  
Samuel Kaplan
Keyword(s):  
Congenital Heart Disease ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Pericardial Effusion ◽  
Congenital Heart ◽  
Review Article ◽  
Noninvasive Method ◽  
Pericardial Disease ◽  
Cardiac Enlargement

In the November 1971 issue of Pediatrics, the review article on the use of radionuclide examinations in children refers to pericardial scanning to diagnose pericardial effusion and to differentiate pericardial disease from cardiac enlargement. This technique has been supplanted by the simple noninvasive method of echocardiography which is highly accurate and without risk. Therefore, radionuclide need not be used in the differential diagnosis of pericardial disease. The review also omits the significant applications of the use of radionuclides in the differential diagnosis of congenital heart disease.

Diseases of the Pericardium, Cardiac Tumors, and Cardiac Trauma

2016 ◽  
Author(s):  
Terrence D. Welch ◽  
Kyle W Klarich ◽  
Jae K. Oh
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Restrictive Cardiomyopathy ◽  
Left Ventricular ◽  
Cardiac Tumors ◽  
Management Options ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Cardiac Trauma ◽  
Pulsed Wave Doppler

The pericardium consists of a fibrous sac and a serous membrane. Because of its simple structure, the clinical syndromes involving the pericardium are relatively few but vary substantially in severity. Cardiac tumors may be either primary or secondary and either benign or malignant, with attachment sites throughout the endocardium. Cardiovascular trauma should be suspected in all patients with chest injuries or severe generalized trauma. Cardiovascular injury may be either blunt or penetrating. This review covers pericardial disease, cardiac tumors, and cardiovascular trauma. Figures show an electrocardiogram in acute pericarditis; acute pericarditis with delayed gadolinium enhancement of the pericardium shown with cardiac magnetic resonance imaging; underlying cause of pericardial effusion requiring pericardiocentesis; pericardial pressure-volume curves; large pericardial effusion with swinging motion of the heart resulting in electrical alternans; typical pulsed-wave Doppler pattern of tamponade; underlying causes of constrictive pericarditis in patients undergoing pericardiectomy; pericardial calcification seen on a chest radiograph; thickened pericardium; typical pulsed-wave Doppler pattern of constrictive pericarditis; typical mitral annular tissue velocities in constrictive pericarditis; a diagnostic algorithm for the echocardiographic diagnosis of constrictive pericarditis; simultaneous right ventricular and left ventricular pressure tracings in restrictive cardiomyopathy; computed tomographic scan showing inflammatory constrictive pericarditis; systolic and diastolic transesophageal echocardiographic images of a large left atrial myxoma attached to the atrial septum; a decision tree of management options for patients with suspected papillary; transesophageal echocardiographic examples of aortic valve, mitral valve, left ventricular outflow tract, and tricuspid valve papillary fibroelastomas; and transesophageal short-axis view of the descending thoracic aorta in a hypotensive patient after a motor vehicle accident. The table lists tamponade versus constriction versus restrictive cardiomyopathy. This review contains 18 highly rendered figures, 1 table, and 77 references.

The pericardium and pericardial disease

2018 ◽  
Author(s):  
David Sidebotham ◽  
Alan Merry ◽  
Malcolm Legget ◽  
Gavin Wright
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Restrictive Cardiomyopathy ◽  
Transoesophageal Echocardiography ◽  
Pericardial Tamponade ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Mechanically Ventilated ◽  
Spectral Doppler ◽  
Echocardiographic Assessment

Chapter 16 is a new chapter from earlier editions of Practical Perioperative Transoesophageal Echocardiography. It provides a short summary on the echocardiographic assessment of the normal pericardium and on pericardial disease. The characteristic TOE features of pericardial pathology (cysts, acute pericarditis, pericardial effusion, pericardial tamponade, and constrictive pericarditis) are reviewed. In particular, pericardial constriction is discussed in detail, including outlining the features that distinguish pericardial constriction from restrictive cardiomyopathy. Wherever possible, the spectral Doppler abnormalities associated with pericardial constriction and pericardial tamponade are discussed with reference to patients who are mechanically ventilated.

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