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Published on: February 17, 2018
Constrictive Pericarditis Mimicking Heart Failure: Hemodynamic Catheterization as the Diagnostic Key
Sina Bakhshaei1,2, Benjamin Szumowski3, Rastina Mehrani4
1Cardiovascular Disease, Temecula Valley Hospital, Temecula, USA.
Insights
Constrictive pericarditis, a reversible cause of heart failure, was diagnosed in a patient with recurrent admissions. Pericardiectomy led to significant symptomatic improvement, highlighting the importance of early diagnosis and intervention.
Area of Science:
- Cardiology
- Internal Medicine
- Cardiovascular Surgery
Background:
- Constrictive pericarditis (CP) is an uncommon cause of heart failure.
- It is characterized by pericardial thickening, fibrosis, and loss of elasticity.
- Early recognition and intervention are crucial for potentially curative treatment.
Abstract:
Constrictive pericarditis (CP) is an uncommon but potentially reversible cause of heart failure, characterized by pericardial thickening, fibrosis, and loss of elasticity. Early recognition is essential because timely intervention can be curative. We report the case of a 64-year-old man with multiple comorbidities and recurrent heart failure admissions who was ultimately diagnosed with CP. Echocardiography suggested constrictive physiology (including annulus reversus), and hemodynamic catheterization demonstrated elevated right atrial pressure with rapid "y" descent, equalization of diastolic pressures across chambers, and a classic square root sign. He underwent pericardiectomy with an uneventful recovery and marked symptomatic improvement. This case highlights the diagnostic complexity of CP and underscores the central role of invasive hemodynamics in distinguishing it from other causes of heart failure, including restrictive cardiomyopathy and diastolic heart failure.
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