title: Constrictive pericarditis with a calcified pericardial band at the level of left ventricle causing mid-ventricular obstruction.
abstract: An adolescent presented with insidious onset and gradually progressive distension of abdomen associated with bilateral ankle swelling of few months duration. He had one episode of prolonged low-grade self-limiting febrile illness during childhood but had not consulted to doctor and never had been diagnosed as case of tuberculosis or acute pericarditis. A detail clinical evaluation showed raised central venous pressure, ascites and ankle oedema. Systemic examination was not much informative except ejection systolic murmur in third left intercostal space. Echocardiography and CT scan heart showed localised thickened pericardium with calcific band around the left ventricle at mid ventricle level. The band around the heart caused the heart to have a 'dumbbell' appearance with ballooning in apical area and a rare mid-ventricular obstruction in the left. A diagnosis of chronic constrictive pericarditis with calcific band was made and the patient was referred to another centre for cardiac surgery.
authors.affiliation: Department of Cardiology, College of Medical Sciences, Bharatpur, Chitwan, Nepal. manigautam@hotmail.com
authors.forename: Mani Prasad
authors.initials: MP
authors.lastname: Gautam
authors.forename: Samir
authors.initials: S
authors.lastname: Gautam
authors.forename: Guruprasad
authors.initials: G
authors.lastname: Sogunuru
authors.forename: Gangapatnam
authors.initials: G
authors.lastname: Subramanyam
mesh_terms: D000293:Adolescent; D002114:Calcinosis / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D004452:Echocardiography; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D010494:Pericarditis, Constrictive / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*
chemical_list: D003287:Contrast Media