title: Recurrent constrictive pericarditis: A diagnostic and therapeutic challenge.
abstract: Recurrent right-sided heart failure after pericardiectomy may be caused by incomplete pericardiectomy, recurrent constriction, diastolic dysfunction or myocardial involvement. Identifying recurrent constrictive pericarditis (CP) in patients who have recurring symptoms after pericardiectomy is challenging, since the characteristic Doppler echocardiographic features may not be present if a portion of the ventricles are free of constricting pericardium, and there are no diagnostic or treatment guidelines for management of recurrent CP. The authors report the case of a 59-year-old man with a history of pericardiectomy for tuberculous CP in 1984, admitted to our hospital with signs and symptoms of right heart failure. After a complete diagnostic workup, recurrent CP was diagnosed. Given the scarcity of cases reported on this disease, three possible therapeutic approaches are discussed: a second pericardiectomy, heart transplantation and medical therapy.
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal. Electronic address: ana_rakel_ferreira@hotmail.com.
authors.forename: Raquel
authors.initials: R
authors.lastname: Ferreira
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
authors.forename: Anabela
authors.initials: A
authors.lastname: Gonzaga
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Santos
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
authors.forename: José António
authors.initials: JA
authors.lastname: Santos
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000628:therapy; D012008:Recurrence
keywords: Pericardectomia; Pericardiectomy; Pericardite constritiva recorrente; Recurrent constrictive pericarditis; Tuberculose; Tuberculosis