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Reversible left ventricular dysfunction simulating a myocardial infarction after pericardiectomy

D E Wood1, A J Crumbley, N L Pereira

  • 1Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 29425-5799 , USA.

Heart (British Cardiac Society)
|July 16, 2002
PubMed

Insights

Post-pericardiectomy constrictive pericarditis can cause temporary left ventricular dysfunction and ECG changes due to myocardial inflammation. This condition resolved with supportive care, highlighting a potential complication of cardiac surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Cardiovascular Imaging

Background:

  • Constrictive pericarditis is a significant complication following pericardiectomy.
  • Left ventricular systolic dysfunction can occur postoperatively.

Observation:

  • A 39-year-old male developed severe left ventricular systolic dysfunction after pericardiectomy for constrictive pericarditis.
  • Electrocardiogram (ECG) showed an anterior wall infarct pattern.
  • Echocardiography revealed no regional wall motion abnormalities.
  • Serum enzymatic tests did not confirm myocardial infarction.

Findings:

  • The patient's left ventricular dysfunction and ECG abnormalities resolved within two weeks with supportive treatment.
  • The transient cardiac dysfunction is hypothesized to be myocardial inflammation and edema secondary to surgical trauma.

Implications:

  • This case suggests that transient left ventricular dysfunction can be a complication of pericardiectomy.
  • Myocardial inflammation and edema should be considered in the differential diagnosis of postoperative cardiac dysfunction after pericardiectomy.
  • Further research may elucidate the mechanisms and optimal management of this surgical complication.

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