title: Extrinsic nonvalvular mitral obstruction due to large epicardial hematoma.
abstract: A case of extrinsic nonvalvular mitral obstruction due to a large epicardial hematoma in a patient with rheumatoid constrictive pericarditis is described. The patient had longstanding rheumatoid arthritis and a mitral diastolic murmur developed. Mitral obstruction was confirmed by a hemodynamic study. Coronary angiography and left ventricular angiography showed severely diseased coronary arteries and a distorted left ventricular cavity. Autopsy demonstrated rheumatoid arthritis, a normal mitral valve, thickened pericardium, and epicardial hematoma surrounding both ventricles at the atrioventricular junctional level.
authors.affiliation: Department of Medicine, University of Nevada School of Medicine, Reno.
authors.forename: A
authors.initials: A
authors.lastname: Shah
authors.forename: D
authors.initials: D
authors.lastname: Melarkey
authors.forename: V T
authors.initials: VT
authors.lastname: Ness
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications; D006349:Heart Valve Diseases / Q000209:etiology; D006406:Hematoma / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology*; D010490:Pericardial Effusion / Q000150:complications*; D010494:Pericarditis, Constrictive / Q000150:complications*