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[Two cases of tuberculous constrictive pericarditis]

T Osawa1, M Seki, Y Uno

  • 1Department of Cardiovascular Surgery, Ishikawa Prefectural Central Hospital, Kanazawa.

Rinsho Kyobu Geka = Japanese Annals of Thoracic Surgery
|December 1, 1994
PubMed
Summary

Tuberculosis can cause constrictive pericarditis, leading to severe heart failure. Surgical treatment (pericardiectomy) effectively improved heart function in these patients.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Constrictive pericarditis is a serious condition characterized by impaired cardiac filling.
  • Tuberculosis is a potential, though often overlooked, etiology for pericardial disease.

Observation:

  • Two patients presented with advanced heart failure (NYHA IV) due to suspected constrictive pericarditis.
  • Diagnostic challenges included negative cultures but elevated Adenosine Deaminase (ADA) levels in effusions.
  • Cardiac catheterization revealed findings consistent with constrictive pericarditis in both cases.

Findings:

  • Pathological examination confirmed tuberculous inflammation as the cause of constrictive pericarditis in both patients.
  • Elevated ADA levels in pericardial and pleural effusions served as a key indicator for tuberculosis.

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Implications:

  • This highlights the importance of considering tuberculosis in the differential diagnosis of constrictive pericarditis, especially in endemic areas.
  • Prompt diagnosis and surgical intervention (pericardiectomy) can significantly improve clinical outcomes and heart function.