scholarly journals Constrictive pericarditis with pericardial calcification

2021 ◽  
Vol 193 (23) ◽  
pp. E853-E853
Author(s):  
Kevin R. An ◽  
Steve K. Singh
Keyword(s):  
Constrictive Pericarditis ◽  
Pericardial Calcification

scholarly journals Disparity in spatial distribution of pericardial calcifications in constrictive pericarditis

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000835 ◽  
Author(s):  
Alpana Senapati ◽  
Hussain A Isma’eel ◽  
Arnav Kumar ◽  
Ayman Ayache ◽  
Chandra K Ala ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Constrictive Pericarditis ◽  
Protective Role ◽  
Apical Segment ◽  
Calcium Scoring ◽  
Imaging Data ◽  
Myocardial Mechanics ◽  
Calcium Distribution ◽  
Pericardial Calcification

BackgroundPericardial calcification is seen among patients with constrictive pericarditis (CP). However, the pattern of pericardial calcium distribution and the association with clinical outcomes and imaging data are not well described.MethodsThis was a retrospective study from 2007 to 2013 to evaluate the pattern of pericardial calcium distribution by CT in CP using a semiquantitative calcium scoring system to calculate total pericardial calcium burden and distribution. Calcium localisation was allocated to 20 regions named after the corresponding heart structure. Baseline clinical data, imaging data and clinical outcomes were collected and compared between the calcified pericardium and non-calcified pericardium groups. We assessed the effect of pericardial calcium on clinical outcomes and echocardiographic data between the two groups.ResultsOf the 123 consecutive patients with CP (93 male; mean age 61±13 years) between 2007 and 2013, 49 had calcified pericardium and 74 had non-calcified pericardium. Distribution of calcium on the left ventricle (LV) basal anterior, mid-anterior and apical segments in addition to right ventricle (RV) apical segment was involved in <30% of the cases with the remaining segments involved in >35% of cases. A potential protective role of RV calcium on regional myocardial mechanics was noted.ConclusionPreferential distribution of calcium in CP in a partial band-like pattern (from basal anterolateral LV going inferiorly and then encircling the heart to reach the RV outflow tract) with extension into the mitral and tricuspid annuli was noted. Pericardial calcium was not significantly associated to clinical outcomes.

Subtotal Pericardiectomy via Sternotomy for Constrictive Pericarditis

2000 ◽  
Vol 8 (2) ◽  
pp. 134-136 ◽  
Author(s):  
Ashok K Srivastava ◽  
Anoop K Ganjoo ◽  
Bashist Misra ◽  
Tapas Chaterjee ◽  
Aditya Kapoor ◽  
...  
Keyword(s):  
New York ◽  
Constrictive Pericarditis ◽  
Left Atrial ◽  
Heart Association ◽  
Functional Class ◽  
Left Atrial Size ◽  
Univariate Logistic Regression Analysis ◽  
Atrial Size ◽  
New York Heart Association ◽  
Pericardial Calcification

Records of 103 patients with constrictive pericarditis who underwent subtotal pericardiectomy from January 1990 to December 1997 were retrospectively analyzed. The etiology of pericardial constriction was unknown in 63, tuberculous in 30, pyogenic in 7, and miscellaneous in 3 patients. Adequate pericardiectomy could be accomplished in 85 (82.5%) patients. Eleven patients (10.68%) died within 30 days of surgery. The 92 survivors were followed up for 47.21 ± 30.7 months; functional status improved in all cases. Of 15 variables examined by univariate logistic regression analysis, preoperative New York Heart Association functional class IV, atrial fibrillation, left atrial size > 40 mm·m−2, mild to moderate mitral regurgitation, tricuspid regurgitation, pericardial calcification, and inadequate pericardiectomy were found to be significant predictors of poor outcome. Adequate pericardiectomy via sternotomy was considered to carry low operative risk and provide excellent improvement in functional capacity.

scholarly journals P1725 An easily dismissed suspect

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H Santos ◽  
I Almeida ◽  
H Miranda ◽  
M Santos ◽  
L Almeida ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Regurgitation ◽  
Emergency Room ◽  
Constrictive Pericarditis ◽  
Nyha Class ◽  
Left Ventricular ◽  
Class I ◽  
Left Ventricular Ejection ◽  
Mineralocorticoid Receptor Antagonist ◽  
Pericardial Calcification

Abstract Funding Acknowledgements None Introduction Constrictive pericarditis (CP) is a rare etiology of heart failure. Is a chronic inflammatory process, characterized by scarring, fibrosis and pericardial calcification. Several etiologies can be associated with CP, namely infectious, idiopathy and post-surgical. In some cases, CP can extend to the myocardium and/or lead to cardiac dysfunction. Case Report 58 years old woman, active smoking, referred to the emergency room for tachycardia on a routine electrocardiogram. History of 5 months of fatigue and dyspnea to ordinary activities, with progressive aggravation in the last month, associated with weight loss and episodic palpitations. Upon the physical examination presented jugular vein engorgement and peripheral edema. Admission electrocardiogram with atrial flutter at 150 of ventricular frequencies, without other findings. Thoracic radiography without variation (tenues pericardium enhancement), abdominal echography with moderate ascites. Blood work showed elevated liver enzymes, BNP of 230pg/ml, exclusion of infectious tuberculosis and autoimmune panel with isolated positive rheumatoid factor. Transthoracic echocardiography (TTE) at the emergency room show a non-dilated and global left ventricle hypokinesia, with reduced left ventricular ejection fraction (LVEF) and dilatation of the mitral valve ring in the genesis of moderate mitral regurgitation. Anticongestive and antiarrhythmic therapy started with rhythm conversion and clinical improve. Thoracic computed tomography scan reveals an extensive pericardial calcification. 2 months later TTE reveal a preserved LVEF, pericardial calcification, moderate mitral regurgitation, grade III diastolic dysfunction, respiration-related ventricular septal shift, increased of the mitral E-wave velocity with an E/A of 2.76, the peak mitral E-wave decreases 36% with the inspiration, dilated inferior vena cava without respiratory variation. Cardiac magnetic resonance imaging exposes a septal bounce and pericardial calcification, suggestive signs of constrictive pericarditis. The patient waits for cardiac catheterization for confirmation, being with anticoagulation, ACE inhibitors, beta-blockers and mineralocorticoid receptor antagonist medication, remaining in NYHA class I. Discussion Clinical suspicion of CP is key for its identification, since there is not a specific clinical manifestation and generally patients presented heart failure symptoms. Echocardiography is best tool for a clinical physician evaluate heart failure etiologies, and can be used with higher sensitivity and specificity associated to the correct criteria to the diagnosis of CP. Pericardiectomy is the standard treatment, however the moment of its performance is not well established, since patients can remain in NYHA class I several years and the surgical procedure have higher mortality rates.

scholarly journals Atrial Fibrillation in Patients with Constrictive Pericarditis: The Significance of Pericardial Calcification

2009 ◽  
Vol 14 (3) ◽  
pp. 258-261 ◽  
Author(s):  
Gholam R. Rezaian ◽  
Masoud Poor-Moghaddas ◽  
Javad Kojuri ◽  
Shahed Rezaian ◽  
Lida Liaghat ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Constrictive Pericarditis ◽  
Pericardial Calcification
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