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Published on: June 29, 2014
Constrictive pericarditis impressing and narrowing the ascending aorta.
Aylin Tugcu1, Ozlem Yildirimturk, Cihan Duran
1Department of Cardiology, Florence Nightingale Hospital, Istanbul, Turkey.
Echocardiography (Mount Kisco, N.Y.)
|August 30, 2008
Summary
Idiopathic constrictive pericarditis, characterized by pericardial calcification, can cause significant cardiac compromise. Surgical pericardiectomy effectively relieved symptoms in this case.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Constrictive pericarditis is a condition where the pericardium, the sac surrounding the heart, becomes stiff and thick, restricting heart function.
- Calcific constrictive pericarditis, though rare, presents diagnostic and therapeutic challenges.
Observation:
- A 77-year-old male presented with dyspnea and edema, exhibiting circumferential pericardial calcification and right pleural effusion on imaging.
- Echocardiography revealed biatrial enlargement and aortic narrowing due to pericardial thickening.
- Cardiac catheterization demonstrated elevated and equalized diastolic pressures, characteristic of constrictive physiology.
Findings:
- Diagnostic imaging, including angiography and MRI, confirmed pericardial calcifications impressing and narrowing the ascending aorta.
- Histological analysis showed dense collagen, inflammation, and calcification, with negative cultures for infectious agents.
- The patient was diagnosed with idiopathic constrictive pericarditis, excluding common causes like tuberculosis or prior surgery.
Implications:
- Surgical pericardiectomy (pericardial stripping) led to significant symptomatic improvement and resolution of edema.
- This case highlights the effectiveness of surgical intervention for idiopathic constrictive pericarditis, even in advanced stages.
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