Primary pericardial mesothelioma presenting as pericardial constriction: a case report.
A 19 year old man presented with a six month history of chest pain, dyspnoea, and lethargy and was found on an echocardiogram to have a dilated left ventricle with a small pericardial effusion. Ramipril and a course of steroids were tried but serial echocardiograms showed a persistently thickened pericardium and slowly developing features of constriction. On computed tomography, a large mediastinal mass encasing the heart, along with para-aortic and paratracheal lymphadenopathy, was found. Right heart catheter studies showed equal pressures in all four chambers. His deteriorating clinical condition led to a pericardiectomy. Histology confirmed primary pericardial mesothelioma. The patient died soon after surgery.
Suman
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Department of Cardiology, Papworth Hospital, Papworth, Cambridge, UK. shivani.suman@virgin.net
Schofield
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D000328:Adult; D002637:Chest Pain / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D017809:Fatal Outcome; D006338:Heart Neoplasms / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000601:surgery; D008654:Mesothelioma / Q000150:complications* / Q000601:surgery; D010494:Pericarditis, Constrictive / Q000209:etiology* / Q000601:surgery; D010496:Pericardium; D014057:Tomography, X-Ray Computed