title: Esophageal varices without portosystemic venous pressure gradient in a patient with post-pericardiotomy constrictive pericarditis: a case report.
abstract: A 51-year-old woman was admitted with intractable congestive heart failure and progressive anemia. She had undergone mitral valve replacement for mitral regurgitation at age 23 years. Subsequently, her mitral prosthesis was replaced twice due to thrombotic stack and valve insufficiency. Signs of congestive heart failure became evident at age 46 years. Gastrointestinal endoscopy revealed esophageal varices, which were treated by endoscopic variceal ligation. Cardiac catheterization disclosed elevated pulmonary capillary wedge pressure (mean 16 mmHg), right atrial pressure (mean 15 mmHg), and hepatic vein wedge pressure (mean 15 mmHg). She died at age 53 years. Autopsy showed severe congestive liver but not liver cirrhosis. Esophageal varices may progress in spite of the absence of porto-systemic pressure gradient in patients with severely high venous pressure.
authors.affiliation: Division of Cardiology, Niigata University Graduate School of Medical & Dental Sciences, Asahimachi-dori 1-757, Niigata, Niigata 951-8510. k-ozaki@med.niigata-u.ac.jp
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ozaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Kodama
authors.forename: Fumio
authors.initials: F
authors.lastname: Yamashita
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Satoru
authors.initials: S
authors.lastname: Hirono
authors.forename: Kiminori
authors.initials: K
authors.lastname: Kato
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D002496:Central Venous Pressure; D004932:Esophageal and Gastric Varices / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000150:complications*; D017082:Portal Pressure