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Clotted hemopericardium with the hemodynamic characteristics of constrictive pericarditis
The American Journal of Cardiology
|February 1, 1980
Insights
Clotted hemopericardium, a collection of blood in the pericardial sac, can mimic constrictive pericarditis. This condition resolved after draining the blood, highlighting a crucial differential diagnosis in cardiac patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pericardial Diseases
Background:
- Constrictive pericarditis presents with characteristic hemodynamic abnormalities.
- Post-cardiac surgery complications require careful evaluation.
Observation:
- A patient presented with hemodynamic findings suggestive of constrictive pericarditis 4 weeks after coronary arterial bypass surgery.
- Cardiac catheterization revealed findings consistent with pericardial constriction.
Findings:
- The patient had a clotted hemopericardium (blood collection within the pericardial sac).
- Hemodynamic abnormalities resolved completely after the removal of 500 ml of clotted pericardial blood.
- The pericardium itself was intact, ruling it out as the cause of constriction.
Implications:
- Clotted hemopericardium is a potential mimic of constrictive pericarditis.
- This case underscores the importance of considering hemopericardium in the differential diagnosis of post-cardiac surgery patients with constrictive physiology.
- Timely diagnosis and management of clotted hemopericardium can prevent unnecessary interventions for constrictive pericarditis.
Abstract:
Cardiac catheterization in a patient 4 weeks after coronary arterial bypass surgery demonstrated the typical hemodynamic findings of constrictive pericarditis, which completely resolved after removal of 500 ml of clotted pericardial blood. The pericardium was not responsible for the findings because it was left in place. This case demonstrates that clotted hemopericardium may mimic constrictive pericarditis.