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Ascites with elevated protein content as the presenting sign of constrictive pericardial disease

Betsy Ann George, Gregory Deprisco, James Ford Trotter

    Proceedings (Baylor University. Medical Center)
    |April 2, 2013
    PubMed

    Insights

    Constrictive pericardial disease can cause high-protein ascites in men. Surgical pericardial excision effectively treated symptoms and improved cardiac function in two cases.

    Area of Science:

    • Cardiology
    • Gastroenterology

    Background:

    • Ascites, characterized by fluid accumulation in the abdomen, can stem from various underlying conditions.
    • High-protein ascites with an elevated serum-ascites albumin gradient (SAAG) often suggests specific etiologies requiring distinct diagnostic and therapeutic approaches.

    Observation:

    • Two male patients, aged 63 and 52, presented with ascites.
    • Ascitic fluid analysis revealed high protein content and an elevated SAAG in both individuals.

    Findings:

    • Constrictive pericardial disease was identified as the cause of ascites in both patients.
    • Surgical excision of the parietal pericardium led to symptom resolution.
    • Post-operative assessment showed decreased cardiac filling pressures and improved cardiac indices.

    Implications:

    • These findings underscore the critical importance of considering constrictive pericardial disease in the differential diagnosis of high-protein ascites.
    • Early recognition and surgical intervention can significantly improve patient outcomes and cardiac hemodynamics.

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