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Massive pericarditis constrictiva calcarea with compression of the right ventricle and consecutive pulmonary embolism

Thomas Butz1, Hakan Yeni, Marc Van Bracht

  • 1Department of Cardiology and Angiology, Marienhospital Herne, Ruhr-University Bochum, Hölkeskampring 40, D-44625 Herne, Germany. thomas.butz@marienhospital-herne.de

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|January 27, 2009
PubMed

Insights

This rare case highlights constrictive pericarditis with massive calcification, right ventricular compression, and pulmonary embolism. Multimodal imaging is crucial for diagnosing complex pericardial conditions and masses.

Area of Science:

  • Cardiology
  • Radiology
  • Pathology

Background:

  • Constrictive pericarditis is a condition where the pericardium becomes stiff and thick, restricting heart function.
  • Calcified constrictive pericarditis, particularly with massive pericardial involvement, is uncommon.
  • Right ventricular compression and thrombus formation are rare complications.

Observation:

  • A 40-year-old male presented with symptoms suggestive of constrictive pericarditis.
  • Echocardiography revealed double-layered pericardial calcification, interspacial effusion, and severe right ventricular compression.
  • Computed tomography (CT) confirmed a right ventricular thrombus leading to pulmonary embolism.

Findings:

  • The patient had massive pericardial calcification causing significant right ventricular compression.
  • A thrombus formed within the right ventricle, resulting in severe pulmonary embolism.
  • Diagnosis was established using a multimodal imaging approach including echocardiography, TDI, MRI, and CT.

Implications:

  • This case underscores the diagnostic utility of multimodal imaging in complex constrictive pericarditis.
  • It highlights the rare but severe complication of right ventricular thrombus formation and subsequent pulmonary embolism.
  • The findings emphasize the importance of considering pericardial masses and calcifications in the differential diagnosis of cardiac compression syndromes.

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