title: Ascites with elevated protein content as the presenting sign of constrictive pericardial disease.
abstract: Two men, one 63 and one 52 years old, presented with ascites. Analysis of the ascitic fluid in both patients revealed a high protein content and an elevated serum-ascites gradient. Various studies showed the cause of the ascites to be constrictive pericardial disease. Total excision of their parietal pericardia relieved their symptoms, decreased their cardiac filling pressures, and increased their cardiac indices. These cases highlight the importance of suspecting pericardial constriction as an etiology for high-protein-count ascites.
authors.forename: Betsy Ann
authors.initials: BA
authors.lastname: George
authors.forename: Gregory
authors.initials: G
authors.lastname: Deprisco
authors.forename: James Ford
authors.initials: JF
authors.lastname: Trotter
authors.forename: Albert Carl
authors.initials: AC
authors.lastname: Henry
authors.forename: Robert Craig
authors.initials: RC
authors.lastname: Stoler
references.citation: Am J Cardiol. 1961 Jan;7:48-61
references.pmid: 13786514
references.citation: J Hepatol. 2000 Jan;32(1):164-9
references.pmid: 10673082
references.citation: Frontline Gastroenterol. 2012 Oct;3(4):233-237
references.pmid: 28839673
references.citation: Ann Thorac Surg. 2012 Aug;94(2):445-51
references.pmid: 22621875
references.citation: J Am Coll Cardiol. 2004 Apr 21;43(8):1445-52
references.pmid: 15093882
references.citation: Ann Intern Med. 1992 Aug 1;117(3):215-20
references.pmid: 1616215
references.citation: Ann Thorac Surg. 2006 Feb;81(2):522-9
references.pmid: 16427843