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[IgG4-related constrictive pericarditis treated by waffle procedure].
Yuichi Matsuzaki1, Yoshihiro Naruse, Keita Tanaka
1Division of Cardiovascular Surgery, Cardiovascular Center, Toranomon Hospital, Tokyo, Japan.
This study presents a case of constrictive pericarditis caused by hyper-immunoglobulin G4 (IgG4) disease. Surgical pericardiectomy relieved heart failure symptoms, confirming IgG4-related pericardial constriction.
Area of Science:
- Cardiology
- Immunology
- Pathology
Background:
- Constrictive pericarditis can lead to heart failure.
- Immunoglobulin G4 (IgG4)-related disease is a systemic inflammatory condition.
Observation:
- A 59-year-old man presented with progressive shortness of breath and leg edema.
- Imaging revealed significant pericardial thickening and signs of right heart strain.
- Cardiac catheterization showed a characteristic dip-and-plateau pattern in the right ventricle.
Findings:
- Pericardiectomy improved hemodynamics and alleviated symptoms.
- Elevated serum IgG4 levels and IgG4-positive plasma cells in the pericardium confirmed IgG4-related disease.
- The patient was diagnosed with constrictive pericarditis secondary to IgG4 disease.
Implications:
- This case highlights IgG4-related disease as a potential cause of constrictive pericarditis.
- Early diagnosis and surgical intervention can improve outcomes in such cases.
- Understanding the role of IgG4 in pericardial disease is crucial for patient management.
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