Related Experiment Video
Updated: May 25, 2026
08:56
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
Asymmetric focal pericardial thickening causing physiologically significant constrictive pericarditis
Nauman Siddiqi1, Morton J Kern, Pranav M Patel
1Division of Cardiology, Department of Medicine, University of California, Irvine, Orange, California 92868, USA.
Summary
Constrictive pericarditis can cause significant heart problems even without widespread pericardial thickening. Multimodality imaging is key to diagnosing this condition, as shown in a refractory ascites case.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Constrictive pericarditis is a cardiac condition characterized by impaired diastolic filling due to pericardial stiffness.
- Diagnosis often relies on imaging, but the extent of pericardial thickening can be variable.
Observation:
- A patient with refractory ascites and edema presented with normal left ventricular function but a restrictive filling pattern on echocardiography.
- Cardiac MRI revealed focal pericardial thickening and delayed enhancement, indicative of inflammation, in both thickened and normal pericardial segments.
Findings:
- Invasive hemodynamics confirmed constrictive physiology.
- The findings demonstrate that significant pericardial inflammation, not necessarily global thickening, can lead to hemodynamically significant constrictive pericarditis.
Implications:
- This case underscores the importance of multimodality imaging, particularly cardiac MRI with delayed enhancement, in diagnosing constrictive pericarditis.
- It highlights that constrictive physiology can occur even with focal pericardial abnormalities, challenging the traditional view of uniform pericardial thickening.
Related Concept Videos
01:19Pericarditis II: Clinical Features and Diagnostic Tests
Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
01:22Pericarditis I: Introduction
Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
01:17Pericarditis III: Medical Management
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
01:23Rheumatic Heart Disease I: Introduction
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...