Effusive-constrictive pericarditis in the absence of overt pericardial disease on multiple imaging modalities.
Effusive-constrictive pericarditis (ECP) is a rare condition that may prove fatal without appropriate treatment. In ECP, there is concomitant existence of a pericardial effusion and CP, that together lead to impaired cardiac filling. Therapeutic pericardiocentesis only addresses part of the problem; surgical pericardiectomy may be required to relieve the constrictive element. Imaging in ECP characteristically demonstrates calcification or thickening of the pericardium. The authors describe a case of ECP were a number of imaging modalities (including echocardiography, cardiac magnetic resonance and CT) did not identify overt pericardial disease. The patient underwent surgical pericardiectomy that led to a rapid resolution of symptoms and full recovery. Histopathological analysis of the pericardial biopsy indicated a non-specific pericardial fibrosis, in keeping with the final diagnosis of ECP.
Aintree Cardiac Centre, University Hospital Aintree, Liverpool, UK. julia.jones2@aintree.nhs.uk
Julia Dawn
JD
Jones
Reza
R
Ashrafi
Steffan P
SP
McDougall
Aleem U
AU
Khand
D004452:Echocardiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000150:complications* / Q000175:diagnosis; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed