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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Multimodality imaging for the diagnosis and treatment of constrictive pericarditis
Michael Chetrit1, Natalie Natalie Szpakowski1, Milind Y Desai1
1Department of Cardiovascular Medicine, Cleveland Clinic, Heart and Vascular Institute , Cleveland , OH , USA.
Insights
Constrictive pericarditis, a cause of heart failure, is diagnosed using multimodality imaging. Cardiac magnetic resonance (CMR) shows promise in guiding treatment and improving outcomes for constrictive pericarditis patients.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Constrictive pericarditis leads to congestive right heart failure, impacting cardiovascular disease morbidity and mortality.
- Multimodality imaging is crucial for diagnosing, managing, and prognosing constrictive pericarditis.
Purpose of the Study:
- To review the clinical spectrum of constrictive pericardial diseases.
- To highlight the role of multimodality imaging in diagnosing constrictive pericarditis.
- To focus on the emerging role of cardiac magnetic resonance (CMR) in managing constrictive pericarditis.
Main Methods:
- Review of recent case series, retrospective, and prospective studies.
- Overview of multimodality imaging techniques for pericardial diseases.
- Emphasis on cardiac magnetic resonance (CMR) applications.
Main Results:
- Advanced imaging identifies pericardial inflammation, aiding in distinguishing reversible disease.
- CMR characterization provides insights into the natural history of pericardial conditions.
- Multimodality imaging guides therapy selection and prognosis assessment.
Conclusions:
- Multimodality imaging, particularly CMR, is vital for the comprehensive management of constrictive pericarditis.
- Identifying reversible pericardial inflammation allows for medical management, potentially avoiding surgery.
- CMR enhances understanding of pericardial disease, improving patient outcomes.
Abstract:
Introduction: Constrictive pericarditis can result in debilitating congestive right heart failure and has been considered an important cause of morbidity and mortality in patients with cardiovascular disease. Multimodality imaging continues to play a fundamental role in the individual approach to diagnosis, management, and prognosis of patients with this clinical syndrome. Areas covered: This article gives an overview of the clinical spectrum of constrictive pericardial diseases and the role of multimodality imaging in the diagnosis of constrictive pericarditis. There is a focus on the emerging role of cardiac magnetic resonance (CMR) for the diagnosis, management, and prognostication of patients with constrictive pericarditis based on more recent case series, retrospective and prospective studies, which have helped to define the role of CMR. Expert opinion: Advanced multimodality imaging assists with identification of both overt and subclinical pericardial inflammation. This allows the pericardiologist to recognize patients with potentially reversible disease, trial medical therapy, and thereby avoid mechanical removal of the pericardium. Further, pericardial characterization by CMR has provided novel information about the natural history of these pericardial conditions, which can help tailor therapy and improve prognosis.
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