Early life threatening constrictive pericarditis following off-pump CABG

Area of Science:

• Cardiology
• Cardiac Surgery
• Oncology

Background:

• Constrictive pericarditis is a rare but serious complication following cardiac surgery.
• Patients with a history of thoracic radiation therapy may be at increased risk.
• Early diagnosis and intervention are crucial for optimal outcomes.

Observation:

• A patient developed aggressive symptomatic constrictive pericarditis within one month post-coronary artery bypass grafting (CABG).
• The patient had a history of Hodgkin's lymphoma treated with radiation and chemotherapy 20 years prior.
• Cardiac imaging revealed constrictive pericardium, patent bypass grafts, and preserved biventricular function.

Findings:

• Constrictive pericarditis was confirmed despite patent grafts and good cardiac function.
• The patient underwent successful pericardiectomy.
• Symptoms resolved remarkably following the surgical intervention.

Implications:

• This case highlights the importance of considering constrictive pericarditis in patients presenting with new cardiac symptoms post-CABG, especially those with prior radiation.
• Prompt diagnosis and surgical management, such as pericardiectomy, can lead to excellent recovery.
• Understanding the risk factors, including prior thoracic radiation, is vital for early detection and prevention strategies.