title: Effusive-constrictive pericarditis as the manifestation of an unexpected diagnosis.
abstract: Constrictive pericarditis is a clinical condition characterized by the appearance of signs and symptoms of right heart failure due to loss of pericardial compliance. Cardiac surgery is now one of the most frequent causes in developed countries, while tuberculosis remains the most prevalent cause in developing countries. Malignancy is a rare cause but usually has a poor prognosis. The diagnosis of constrictive pericarditis remains a clinical challenge and requires a combination of noninvasive diagnostic methods (echocardiography, cardiac magnetic resonance and computed tomography); in some cases, cardiac catheterization is needed to confirm the diagnosis. The authors present the case of a 51-year-old man, hospitalized due to cardiac tamponade. Diagnostic investigation was suggestive of tuberculous etiology. Despite directed medical therapy, the patient developed effusive-constrictive physiology. He underwent pericardiectomy and anatomopathologic study suggested a neoplastic etiology. The patient died in the postoperative period from biventricular failure.
authors.affiliation: Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal. Electronic address: liliana.marta@gmail.com.
authors.forename: Liliana
authors.initials: L
authors.lastname: Marta
authors.affiliation: Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Alves
authors.affiliation: Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal.
authors.forename: Marisa
authors.initials: M
authors.lastname: Peres
authors.affiliation: Serviço de Cirurgia Cardiotorácica, Hospital de Santa Maria - CHLN, Lisboa, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ferreira
authors.affiliation: Serviço de Cirurgia Cardiotorácica, Hospital de Santa Maria - CHLN, Lisboa, Portugal.
authors.forename: Hugo
authors.initials: H
authors.lastname: Ferreira
authors.affiliation: Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Leal
authors.affiliation: Serviço de Cirurgia Cardiotorácica, Hospital de Santa Maria - CHLN, Lisboa, Portugal.
authors.forename: Ângelo
authors.initials: Â
authors.lastname: Nobre
mesh_terms: D010494:Pericarditis, Constrictive / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery
keywords: Cardiac magnetic resonance; Diagnosis; Diagnóstico; Echocardiography; Ecocardiografia; Effusive‐constrictive pericarditis; Heart failure; Insuficiência cardíaca; Pericardite efusiva‐constritiva; Ressonância magnética cardíaca