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Chronic constrictive pericarditis complicated with huge right atrial thrombus in a child with abdominal tuberculosis:

Rupesh Kumar1, Javid Raja1, Sanjib Rawat1

  • 1Department of Cardiothoracic and Vascular Surgery, Advanced Cardiac Center, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.

Journal of Surgical Case Reports
|November 15, 2019
PubMed

Insights

Chronic constrictive pericarditis (CCP) can rarely lead to intracardiac thrombus. Early detection via transesophageal echocardiography is crucial to prevent life-threatening pulmonary embolism during surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • Chronic constrictive pericarditis (CCP) is the most frequent pericardial disease.
  • Intracardiac thrombus formation is a rare but serious complication of CCP.

Observation:

  • Preoperative identification of intracardiac thrombus is vital to prevent pulmonary thromboembolism during anterior pericardiectomy.
  • Transesophageal echocardiography demonstrates superior sensitivity for detecting atrial thrombus compared to transthoracic echocardiography.

Findings:

  • Transesophageal echocardiography is the preferred imaging modality for identifying intracardiac thrombi in CCP patients.
  • Surgical intervention, including cardiopulmonary bypass, is indicated for the removal of right atrial thrombi.

Implications:

  • Timely diagnosis and surgical management of intracardiac thrombi in CCP can significantly improve patient outcomes.
  • This highlights the importance of advanced echocardiographic techniques in managing complex pericardial diseases.

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