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Constrictive Pericarditis as a Long-term Undetermined Etiology of Ascites and Edema

Takahiro Kamio1, Eiji Hiraoka2, Kotaro Obunai1

  • 1Heart Center, Tokyo Bay Urayasu-Ichikawa Medical Center, Japan.

Internal Medicine (Tokyo, Japan)
|January 12, 2018
PubMed

Insights

Constrictive pericarditis, a heart condition mimicking liver disease, presents diagnostic challenges. Early suspicion is key to differentiating it from primary liver conditions like cirrhosis.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Gastroenterology

Background:

  • Constrictive pericarditis (CP) impedes diastolic filling due to pericardial fibrosis.
  • CP diagnosis is challenging, requiring high clinical suspicion.
  • Symptoms like edema, ascites, and liver dysfunction can mimic primary liver disease.

Observation:

  • A 69-year-old woman presented with a 7-year history of leg edema and 2-year history of ascites.
  • Initial diagnosis was cryptogenic liver cirrhosis.
  • The patient was ultimately diagnosed with constrictive pericarditis.

Findings:

  • Constrictive pericarditis can present with symptoms overlapping those of liver cirrhosis.
  • Misdiagnosis is common due to shared clinical manifestations.
  • A high index of suspicion is crucial for accurate CP diagnosis.

Implications:

  • Highlights the importance of considering constrictive pericarditis in patients with unexplained ascites and edema.
  • Emphasizes the need for thorough diagnostic evaluation to differentiate CP from liver disease.
  • Suggests improved diagnostic strategies are needed for constrictive pericarditis.

Keywords:
ascitesconstrictive pericarditis

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