[Diastolic restriction caused by an encysted hemopericardium a year after coronary bypass].
The case of a 54 year old patient presenting with congestive cardiac failure one year after single aorto-coronary bypass surgery is reported. Paraclinical investigations showed a pericardial effusion compressing the inferior wall of the heart. Echocardiography was essential for diagnosis. This localised compression was responsible for the haemodynamic changes of adiastole. Pericardial drainage confirmed the diagnosis of an encysted hemopericardium containing about 300 ccs of liquid. Right and left cardiac catheter studies before and after surgery, and 8 months postoperatively, showed progressive normalisation of the intracardiac pressures. A volume expansion stress test excluded possible associated pericardial constriction. Therefore, the finding of diastolic restriction with a residual effusion after cardiac surgery should orientate management towards pericardial drainage before considering pericardectomy.
D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004452:Echocardiography; D006333:Heart Failure / Q000209:etiology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion; D010494:Pericarditis, Constrictive / Q000209:etiology* / Q000601:surgery
Restriction diastolique par hémopéricarde enkysté un an après pontage coronaire.