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[Chronic constrictive pericarditis. 27 cases].

P Cacoub1, B Wechsler, C Chapelon

  • 1Service de Médecine interne, Groupe hospitalier Pitié-Salpêtrière, Paris.

Presse Medicale (Paris, France : 1983)
|December 14, 1991
PubMed
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This study on chronic constrictive pericarditis found that imaging techniques like echocardiography and CT scans are crucial for diagnosis and treatment planning. Early surgical intervention, specifically pericardectomy, is vital for improving patient survival and functional outcomes.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Medical Imaging

Background:

  • Chronic constrictive pericarditis is a serious condition often following acute pericarditis.
  • Diagnosis and management have evolved with advancements in imaging and surgical techniques.

Purpose of the Study:

  • To analyze the diagnostic methods, causes, treatments, and outcomes of chronic constrictive pericarditis.
  • To evaluate the effectiveness of medical and surgical interventions.

Main Methods:

  • Retrospective analysis of 27 chronic constrictive pericarditis cases (1975-1990).
  • Utilized echocardiography, computerized tomography (CT), and cardiac catheterization for diagnosis.
  • Reviewed causes, medical treatments (corticosteroids, antituberculous therapy), and surgical interventions (pericardial drainage, pericardectomy).

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Main Results:

  • Echocardiography and CT scans were effective in diagnosing pericardial effusion, thickening, and cardiac compression.
  • Neoplasia, radiotherapy, and fibrosis were identified causes, with idiopathic cases accounting for 50%.
  • Surgery, particularly pericardectomy, was required in 25 patients, with significantly better outcomes than medical management alone.

Conclusions:

  • Echocardiography and CT provide sufficient data for therapeutic decisions, often negating the need for invasive hemodynamic assessment.
  • Early pericardectomy is crucial for favorable functional results and long-term survival in constrictive pericarditis.
  • While tuberculosis is now rare, other causes like neoplasia and post-surgical complications are more frequent; corticosteroids are beneficial only in highly inflammatory cases.