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Related Concept Videos

Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
139
Pericarditis I: Introduction01:22

Pericarditis I: Introduction

106
Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
106
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

96
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
96
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

146
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
146
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

171
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
171
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

173
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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An Intact Pericardium Ischemic Rodent Model
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Delayed-onset constrictive pericarditis associated with trauma.

Yuto Suetani1, Yoh Arita2, Akira Marumoto3

  • 1Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, Osaka, Japan.

BMJ Case Reports
|March 17, 2021
PubMed
Summary

Surgical pericardiectomy effectively treated constrictive pericarditis (CP) and heart failure unresponsive to medical management. This intervention resolved symptoms like dyspnoea and oedema in a patient with trauma-induced CP.

Keywords:
heart failurepericardial disease

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Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Constrictive pericarditis (CP) is a condition where the pericardium becomes stiff, impairing heart function.
  • Trauma-induced CP can lead to chronic heart failure, often resistant to medical therapy.

Observation:

  • A 59-year-old male presented with a 6-month history of exertional dyspnoea and pretibial oedema.
  • Diagnostic evaluations including CT, echocardiography, and cardiac catheterisation confirmed heart failure secondary to constrictive pericarditis.
  • The patient's condition was refractory to medical treatments.

Findings:

  • Surgical pericardiectomy was performed as the definitive treatment for the constrictive pericarditis.
  • Pathological analysis of the resected pericardium showed fatty texture, dense fibrous connective tissues, old haemorrhage, and focal calcification.
  • Post-surgery, the patient's symptoms improved significantly, with New York Heart Association Class I status and resolution of peripheral oedema.

Implications:

  • Surgical pericardiectomy is a viable and effective treatment for long-standing, trauma-induced constrictive pericarditis with heart failure.
  • Early diagnosis and surgical intervention may improve long-term outcomes for patients with refractory CP.
  • Understanding the pathological characteristics of the pericardium can aid in diagnosing and managing CP.