scholarly journals Pericardial thickening

2019 ◽  
Author(s):  
Daniel Bell ◽  
Yuranga Weerakkody
Keyword(s):  
Pericardial Thickening

Suspected acute rheumatic fever in a young man in England

2021 ◽  
Vol 14 (11) ◽  
pp. e244469
Author(s):  
Zak Michael Wilson ◽  
Katie Craster
Keyword(s):  
Chest Pain ◽  
General Practitioner ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Supportive Therapy ◽  
Acute Hospital ◽  
Shortness Of Breath ◽  
Pleural Effusions ◽  
Pericardial Thickening

A 24-year-old fit and well Caucasian man was referred to acute hospital via his General Practitioner with chest pain, palpitations, shortness of breath and an antecedent sore throat. Investigations revealed pericardial and pleural effusions, pericardial thickening on MRI, mild mitral regurgitation on echocardiogram and a raised Antistreptolysin O (ASO) titre.He was treated as acute rheumatic fever (ARF) with a prolonged course of penicillin, supportive therapy with bisoprolol and colchicine with lansoprazole cover. The patient made a full recovery and subsequent cardiac MRI showed resolution of all changes.

scholarly journals Graft-versus-host disease: a case report of a rare but reversible cause of constrictive pericarditis

2020 ◽  
Vol 4 (2) ◽  
pp. 1-5
Author(s):  
Christopher A Pieri ◽  
Neil Roberts ◽  
John Gribben ◽  
Charlotte Manisty
Keyword(s):  
Constrictive Pericarditis ◽  
Hospital Admissions ◽  
High Dose Chemotherapy ◽  
Immunomodulatory Therapy ◽  
High Dose ◽  
Pericardial Disease ◽  
Host Disease ◽  
Graft Vs Host Disease ◽  
Pericardial Thickening ◽  
Small Pericardial Effusion

Abstract Background  Constrictive pericarditis (CP), although an uncommon cause of heart failure, requires specialist multidisciplinary input and multi-modality imaging to identify the underlying aetiology and treat potentially reversible causes. Case summary  We report the case of a 74-year-old gentleman referred for assessment of progressive exertional dyspnoea and peripheral oedema, 30 months following treatment of acute myeloid leukaemia with high-dose chemotherapy and allogeneic stem cell transplantation. Clinical examination and cardiac imaging revealed a small pericardial effusion and pericardial thickening with constrictive physiology; however, no aetiology was identified despite diagnostic pericardiocentesis. The patient required recurrent hospital admissions for intravenous diuresis, therefore, following multidisciplinary discussions, surgical partial pericardectomy was performed. Histology suggested graft-vs.-host disease (GvHD) and post-operatively, the patient improved clinically. Following immunomodulatory therapy with ruxolitinib for both pericardial and pulmonary GvHD, his functional status improved further with no subsequent hospital admissions. Discussion  Although pericardial disease in cancer patients is common, CP is unusual. Determining the underlying aetiology is important for subsequent management, and here, we describe the use of multi-modality imaging to diagnose a rare cause, GvHD, which responded to surgical treatment and immunomodulatory therapy.

scholarly journals P395Not all pericardial thickening is effusion: usefulness of CMR in the characterization of epicardial lipomatous hypertrophy

2019 ◽  
Vol 20 (Supplement_2) ◽  
Author(s):  
F M Caballeros ◽  
M Garcia De Yebenes ◽  
V Suarez ◽  
A Suarez ◽  
A Hernandez ◽  
...  
Keyword(s):  
Lipomatous Hypertrophy ◽  
Pericardial Thickening

scholarly journals A giant fibrinoid pericardial mass in a patient with rheumatoid arthritis: a case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Felipe Cañas ◽  
Juan David Lopez Ponce de León ◽  
Juan Esteban Gomez ◽  
Carlos Alberto Cañas
Keyword(s):  
Rheumatoid Arthritis ◽  
Right Ventricle ◽  
Chronic Inflammatory Disease ◽  
Pericardial Disease ◽  
Prognostic Features ◽  
Cardiac Manifestation ◽  
Histopathological Studies ◽  
The Right ◽  
Pericardial Mass ◽  
Pericardial Thickening

Abstract Background  Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints, which may extend to extra-articular organs. Extra-articular manifestations have been considered as prognostic features in RA, and pericardial disease is one of the most frequent occurrences. Rheumatoid arthritis pericarditis is usually asymptomatic and is frequently found on echocardiography as pericardial thickening with or without mild effusion. Severe and symptomatic cases are rare, but pericardial masses are even rarer. We report a patient with erosive, nodular seropositive RA, and progressive functional deterioration owing to a giant pericardial mass compressing the right cardiac chambers. Case summary The patient was a 79-year-old man. Cardiac magnetic resonance imaging revealed a pericardial lesion measuring 10 × 9 × 6 cm with complex structures in its interior, which had compressive effects on the right atrium and right ventricle, severely limiting diastole. Late gadolinium enhancement of the lesion walls and pericardium suggested pericarditis. Surgical resection was performed, and a soft mass with liquid content was extracted. The patient recovered well with improvements in symptoms and the functional status. Histopathological studies ruled out neoplasm, vasculitis, and infection, and the entire mass showed fibrinoid material associated with fibrinoid pericarditis. Discussion Symptomatic RA pericarditis is a rare cardiac manifestation of RA, whilst associated significant haemodynamic compromise is even rarer. The condition could manifest with a giant compressive pericardial mass composed of fibrinous material, with particular involvement of the right ventricle. Exclusion of other conditions, such as neoplasms and infections, is necessary.

scholarly journals Chylopericardium associated with constrictive pericarditis assessed by multimodality imaging

2021 ◽  
Author(s):  
Emmanuel Androulakis ◽  
Konstantinos Bratis ◽  
TP Chua ◽  
Venkatachalam Chandrasekaran
Keyword(s):  
Computed Tomography ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Male Patient ◽  
Constrictive Pericarditis ◽  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Interesting Case ◽  
Exertional Dyspnea ◽  
Pericardial Thickening

Abstract An 80-year-old male patient developed exertional dyspnea and bilateral peripheral oedema. Investigations including an echocardiogram, cardiac computed tomography and cardiac magnetic resonance suggested calcific pericardial thickening encapsulating the heart with associated constriction. This is an interesting case as constriction was associated with a large chylopericardium of unknown cause

scholarly journals P187 Multimodality in tuberculous constrictive pericarditis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Leite De Barros Filho ◽  
H T Moreira ◽  
M K Santos ◽  
A Schmidt ◽  
R C Santana ◽  
...  
Keyword(s):  
Constrictive Pericarditis ◽  
Low Cost ◽  
Vena Cava ◽  
Left Ventricular ◽  
Etiologic Agent ◽  
Functional Evaluation ◽  
Initial Image ◽  
The Right ◽  
Active Inflammation ◽  
Pericardial Thickening

Abstract CASE PRESENTATION K.C.P., a 26 y.o. female, presenting dizziness and progressive dyspnea since 9 months ago. Physical examination showed hepatomegaly at 2 centimeters below the right inferior costal border, but without edema, cardiac murmurs or other findings. Electrocardiogram showed atria overload and diffuse ventricular repolarization abnormality. Chest X-ray revealed normal sized cardiac silhouette but with signs of pericardial calcification. Transthoracic echocardiogram revealed: enlargement of both atria, no signs of myocardial left ventricular (LV) hypertrophy; dilated inferior vena cava with minimal respiratory variation; septal bounce; septal e´= 17.20 cm/s, lateral e´= 6.09 cm/s; E/e" septal ratio = 3.9; E deceleration time = 144 ms; thickening and hyper-refringence of the pericardium with calcification adjacent to the lateral and inferior walls of the LV and the free wall of the right ventricle. For evaluation of thickness and extent of pericardial involvement, computed tomography (CT) was performed, showing gross calcifications of the pericardium, mainly in basal and lower portions, without pericardial effusion. Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement revealed areas suggestive of active inflammation adjacent to the basal wall of the LV. With this evidence of active inflammatory activity, the patient was treated empirically against the etiologic agent for tuberculosis. Because of progressively severe edema and dyspnea pericardiectomy was warranted providing relief of symptoms. DISCUSSION: The echocardiogram is the initial image exam for diagnosis and monitoring of pericardial conditions. It is a widely available, low-cost method that does not use ionizing radiation and allows a complete morphological and functional evaluation of the heart. However, in up to 20% of cases, pericardial thickening may not be detectable at echocardiography. CT allows a more accurate assessment of pericardial thickening, while CMR allows detection of active inflammatory process. CONCLUSION: A typical and illustrative clinical case of constrictive pericarditis is presented, where the multimodality of cardiac imaging was decisive for the diagnostic and therapeutic delineation.

A Case of Constrictive Pericarditis with Mild Pericardial Thickening

2010 ◽  
Vol 39 (6) ◽  
pp. 309-313
Author(s):  
Kazuyoshi Kanno ◽  
Taira Kobayashi ◽  
Tatsuhiko Komiya
Keyword(s):  
Constrictive Pericarditis ◽  
Pericardial Thickening

scholarly journals Poststernotomy Osteomyelitis Presenting with Severe Sepsis and Rhabdomyolysis

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Eugene M. Tan ◽  
Melissa Lyle ◽  
Kelly Cawcutt ◽  
Zelalem Temesgen
Keyword(s):  
Severe Sepsis ◽  
Aortic Root ◽  
Resonance Imaging ◽  
Severe Liver ◽  
Mri Findings ◽  
Sternal Osteomyelitis ◽  
Severe Liver Dysfunction ◽  
Magnetic Resonance Imaging Mri ◽  
Delays In Diagnosis ◽  
Pericardial Thickening

A 39-year-old male, who recently underwent a composite valve graft of the aortic root and ascending aorta for bicuspid aortic valve and aortic root aneurysm, was hospitalized for severe sepsis, rhabdomyolysis (creatine kinase 29000 U/L), and severe liver dysfunction (AST > 7000 U/L, ALT 4228 U/L, and INR > 10). Cardiac magnetic resonance imaging (MRI) findings were consistent with sternal osteomyelitis with a 1.5 cm abscess at the inferior sternotomy margin, which was contiguous with pericardial thickening. Aspiration and culture of this abscess did not yield any organisms, so he was treated with vancomycin and cefepime empirically for 4 weeks. Because this patient was improving clinically on antibiotics and did not show external signs of wound infection, there was no compelling indication for sternectomy. This patient’s unusual presentation with osteomyelitis and rhabdomyolysis has never been reported and is crucial for clinicians to recognize in order to prevent delays in diagnosis.

Imaging Features of Constrictive Pericarditis: Beyond Pericardial Thickening

2009 ◽  
Vol 60 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Giuseppe Napolitano ◽  
Josephine Pressacco ◽  
Eleonore Paquet
Keyword(s):  
Magnetic Resonance Imaging ◽  
Constrictive Pericarditis ◽  
Clinical Suspicion ◽  
Diastolic Filling ◽  
Diagnostic Feature ◽  
Imaging Features ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Pericardial Thickening

Constrictive pericarditis is caused by adhesions between the visceral and parietal layers of the pericardium and progressive pericardial fibrosis that restricts diastolic filling of the heart. Later on, the thickened pericardium may calcify. Despite a better understanding of the pathophysiologic basis of the imaging findings in constrictive pericarditis and the recent advent of magnetic resonance imaging (MRI) technology, which has dramatically improved the visualization of the pericardium, the diagnosis of constrictive pericarditis remains a challenge in many cases. In patients with clinical suspicion of underlying constrictive pericarditis, the most important radiologic diagnostic feature is abnormal pericardial thickening, which can be shown readily by computed tomography (CT) and especially by MRI, and is highly suggestive of constrictive pericarditis. Nevertheless, a thickened pericardium does not always indicate constrictive pericarditis. Furthermore, constrictive pericarditis can occur without pericardial thickening.

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