- MeSH
- Pulmonary Artery microbiology MeSH
- Arteritis diagnosis drug therapy MeSH
- Pericarditis, Constrictive diagnosis drug therapy MeSH
- Humans MeSH
- Adolescent MeSH
- Lupus Erythematosus, Systemic MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Pericarditis, Constrictive diagnosis etiology MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
Konstriktivní perikarditida je relativně vzácnou chorobou, charakterizovanou chronickým jizvením a srůstem listů osrdečníku, vedoucí ke ztrátě perikardiální elasticity a vzniku rigidního obalu srdce, omezujícího externě jeho plnění. Základem správné diagnostiky konstriktivní perikarditidy je znalost typických hemodynamických známek, podmíněných restrikcí komorového plnění, disociací intratorakálních a intrakardiálních tlaků a zvýrazněnou interventrikulární dependencí. Autoři v tomto sdělení podávají přehled echokardiografické diagnostiky konstriktivní perikarditidy, především s ohledem na odlišení od restriktivní kardiomyopatie. Pouze správná diagnostika konstriktivní perikarditidy umožňuje adekvátní léčbu této choroby, která spočívá v co možná nejradikálnější chirurgické perikardektomii.
Constrictive pericarditis (CP) is a relatively rare disorder, characterized by chronic scarring and fusing of layers of pericardium, resulting in the loss of pericardial elasticity and formation of a rigid shell covering the heart and externally limiting its filling. The basis for correctly diagnosing CP is good knowledge of typical hemodynamic features resulting from restriction of ventricular filling, dissociation of intrathoracic and intracardiac pressures and increased interventricular dependence. In this article, the authors summarize echocardiographic assessment of CP, especially with regards to differentiation from restrictive cardiomyopathy. Only with correct diagnostics of CP it is possible to carry out adequate therapy, which consists of radical surgical pericardectomy.
Zánět osrdečníku neboli perikarditida je relativně vzácné onemocnění srdce. V našich podmínkách bývají nejčastějším etiologickým agens viry. Mezi vzácnější agens patří Mycobacterium tuberculosis, typičtější spíše v rozvojových zemích. Komplikace nebývají časté, mezi nejčastější komplikace perikarditidy však patří vznik výpotku, rozvoj srdeční tamponády, konstriktivní perikarditida nebo rozvoj myoperikarditidy. Uvádíme případ 52letého pacienta, u něhož byla indikována totální perikardektomie pro tuberkulózní konstriktivní perikarditidu.
Pericarditis is a relatively rare heart disease. In our conditions, the most common etiological agent is viruses. Rarer agents include Mycobacterium tuberculosis, more typical in developing countries. Complications are not frequent, but the most common complications of pericarditis include the formation of an effusion, the development of cardiac tamponade, constrictive pericarditis or the development of myopericarditis. We present the case of a 52-year-old patient indicated for total pericardectomy for tuberculous constrictive pericarditis.
- MeSH
- Adult MeSH
- Electrocardiography methods MeSH
- Pericarditis, Constrictive * diagnosis MeSH
- Humans MeSH
- Mycobacterium tuberculosis pathogenicity MeSH
- Pericardium surgery microbiology pathology MeSH
- Pericardiectomy methods MeSH
- Tuberculosis microbiology therapy virology MeSH
- Pericarditis, Tuberculous diagnosis MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Konstriktivní perikarditida je definována jako porucha srdeční funkce v diastole vedoucí k rozvoji srdečního selhání, postupnému přetížení tekutinami, systémovému žilnímu městnání a snížení srdečního výdeje. I když konstrikce postihuje obě komory, převládají symptomy pravostranného srdečního selhání. Při konstriktivní perikarditidě se lze setkat s městnavým srdečním selháním i s normální systolickou funkcí levé komory. Za hlavní metodu léčby konstriktivní perikarditidy se považuje perikardiektomie. V tomto článku popisujeme případ úspěšné perikardiektomie provedené u 68leté ženy.
Constrictive pericarditis is defined as impaired diastolic cardiac function leading to heart failure, progressive fluid overload, systemic venous congestion and reduction of cardiac output. Both ventricles affected by the constriction, however, symptoms of right heart failure dominate. The congestive heart failure and normal left ventricular systolic functions are seen in the presence of constrictive pericarditis. Pericardiectomy is considered as the mainstay treatment method for constrictive pericarditis. Here we present successful pericardiectomy of a 68-year-old female.
- MeSH
- Dyspnea etiology MeSH
- Pericarditis, Constrictive * diagnosis complications therapy MeSH
- Humans MeSH
- Pericardiectomy * methods MeSH
- Pericarditis diagnosis complications therapy MeSH
- Aged MeSH
- Heart Failure etiology complications therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
This study sought to determine the clinical utility of a new catheterization criterion for the diagnosis of constrictive pericarditis (CP). BACKGROUND: The finding of early rapid filling and equalization of end-diastolic pressures obtained by cardiac catheterization are necessary for the diagnosis of CP, but these findings are also present in patients with restrictive myocardial disease (RMD). Enhanced ventricular interaction is unique to CP. METHODS: High-fidelity intracardiac pressure waveforms from 100 consecutive patients undergoing hemodynamic catheterization for diagnosis of CP versus RMD were examined. Fifty-nine patients had surgically documented CP and comprised group 1; the remaining 41 patients with RMD comprised group 2. The ratio of the right ventricular to left ventricular systolic pressure-time area during inspiration versus expiration (systolic area index) was used as a measurement of enhanced ventricular interaction. RESULTS: There were statistically significant differences in the conventional catheterization criteria between CP and RMD, but the predictive accuracy of any of the criteria was <75%. The systolic area index had a sensitivity of 97% and a predictive accuracy of 100% for the identification of patients with surgically proven CP. CONCLUSIONS: The ratio of right ventricular to left ventricular systolic area during inspiration and expiration is a reliable catheterization criterion for differentiating CP from RMD, which incorporates the concept of enhanced ventricular interdependence.
- MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Hemodynamics MeSH
- Ventricular Pressure MeSH
- Pericarditis, Constrictive diagnosis physiopathology MeSH
- Myocardial Contraction genetics MeSH
- Middle Aged MeSH
- Humans MeSH
- Predictive Value of Tests MeSH
- Cardiomyopathy, Restrictive diagnosis MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Sensitivity and Specificity MeSH
- Cardiac Catheterization MeSH
- Heart Ventricles anatomy & histology pathology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
Popisujeme případ 68leté nemocné, která před 25 lety podstoupila totální mastektomii pro karcinom levého prsu s následnou chemo a radioterapií. Přibližně 1 rok byla vyšetřována pro narůstající dušnost, suchý kašel, otoky dolních končetin a recidivující oboustranný fluidotorax. Diferenciálně diagnosticky byla zvažována recidiva onkologického onemocnění, plicní choroba či městnavá srdeční slabost. Díky transtorakální echokardiografii byla vyslovena suspekce na konstriktivní perikarditidu a tato diagnóza byla verifikována hemodynamickým vyšetřením s následným chirurgickým řešením, tj. perikardektomií.
Our work presents the case of 68-year-old woman, which underwent a full mastectomy for carcinoma of the left breast about 25 years ago followed by chemotherapy and radiotherapy. She was about one year investigated for increasing dyspnea, dry cough, swelling of the legs and recurrent sided fluidotorax. Recurrence of cancer, lung disease or congestive heart failure was considered. By using of echocardiography it was raised suspicion for constrictive pericarditis and the diagnosis was verified by haemodynamic examination. She was refered to the department of cardiosurgery and pericardiectomy was done.
- MeSH
- Dyspnea etiology MeSH
- Echocardiography MeSH
- Hemodynamics MeSH
- Pericarditis, Constrictive * diagnosis surgery physiopathology MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Pericardiectomy MeSH
- Radiation Injuries * MeSH
- Radiotherapy * adverse effects MeSH
- Aged MeSH
- Cardiac Catheterization MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Aim. A case report of subacute effusive-constrictive pericarditis in a patient with iatrogenic hemopericardium is presented. Methods. A 69-year-old man was referred to our department for percutaneous coronary intervention complicated with hemopericardium with cardiac tamponade. Continuous bleeding after pericardiocentesis required an urgent surgical revision with evacuation of hemopericardium and local treatment of the sources of bleeding. A mild to moderate pericardial effusion persisted in the post-operative period, without any symptoms of cardiac tamponade. A global heart failure developed in the patient eleven months after complicated coronary intervention (surgical revision). A technically successful pericardiocentesis did not improve the clinical state of the patient. Echocardiography and magnetic resonance imaging confirmed the diagnosis of effusive-constrictive pericarditis. Results. Subsequent pericardiectomy resulted in a prompt and complete relief of symptoms and signs of heart failure. Conclusion. Effusive-constrictive pericarditis is an uncommon disorder characterised by symptoms of refractory cardiac failure, thickening of the visceral pericardium and pericardial effusion, with no improvement after pericardiocentesis. In indicated cases, pericadiectomy leads to recovery in a large percentage of patients.
- MeSH
- Angioplasty, Balloon, Coronary adverse effects MeSH
- Pericarditis, Constrictive etiology surgery MeSH
- Coronary Vessels injuries MeSH
- Humans MeSH
- Pericardiectomy MeSH
- Pericardial Effusion etiology surgery MeSH
- Pericardiocentesis MeSH
- Reoperation MeSH
- Aged MeSH
- Cardiac Tamponade etiology MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
