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Constrictive pericarditis caused by an old hematoma
Insights
A rare case of constrictive pericarditis caused by an old hematoma was successfully treated with surgical resection. This intervention relieved elevated cardiac pressures and improved the patient's condition.
Area of Science:
- Cardiology
- Pathology
Background:
- Constrictive pericarditis can significantly elevate cardiac pressures.
- Recurrent pericardial effusions may indicate underlying chronic conditions.
Observation:
- A 46-year-old woman presented with symptoms of constrictive pericarditis.
- Previous history of acute pericarditis with pericardiocentesis 10 years prior.
- Cardiac catheterization revealed elevated right-atrial and pulmonary wedge pressures.
Findings:
- Chest CT identified a retrosternal calcified mass.
- Surgical exploration revealed a hard mass with atheromatous content adhered to the epicardium near the right atrioventricular groove.
- Pathological examination confirmed the mass to be an old hematoma.
Implications:
- Surgical resection of the hematoma resolved the constrictive pericarditis.
- This case highlights an unusual etiology for constrictive pericarditis.
- Prompt diagnosis and surgical intervention are crucial for managing such rare cardiac conditions.
Abstract:
A 46-year-old woman was admitted for surgery after diagnosis of a constrictive pericarditis. She had suffered from acute pericarditis and undergone pericardiocentesis to relieve pericardial effusion several times 10 years previously. Cardiac catheterization showed elevated mean right-atrial and pulmonary wedge pressures. Chest CT revealed only a calcified mass in the retrosternal space. At surgery, there was no severe adhesion between the pericardium and the epicardium, and the pericardium was thin and almost normal except over the right artio-ventricular groove, where a hard mass with an atheromatous content adhered to the epicardium. After resection of the mass, central venous pressure and pulmonary wedge pressure decreased. The mass was found to be an old hematoma by pathological examination. The patient was subsequently discharged from hospital in good condition.