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Restrictive pericarditis

Livia Garavelli, Ilenia Maini, Federica Baccilieri, Ivan Ivanovski, Marzia Pollazzon, Simonetta Rosato, Lorenzo Iughetti, Sheila Unger, Andrea Superti-Furga, Marco Tartaglia
UNLABELLED: Myhre syndrome (OMIM 139210) is a rare developmental disorder inherited as an autosomal dominant trait and caused by a narrow spectrum of missense mutations in the SMAD4 gene. The condition features characteristic face, short stature, skeletal anomalies, muscle pseudohypertrophy, restricted joint mobility, stiff and thick skin, and variable intellectual disability. While most of the clinical features manifest during childhood, the diagnosis may be challenging during the first years of life...
October 2016: European Journal of Pediatrics
Marta Madeira, Rogério Teixeira, Marco Costa, Lino Gonçalves, Allan L Klein
Transthoracic echocardiography has a pivotal role in the diagnosis of constrictive pericarditis (CP). In addition to the classic M-mode, two-dimensional and Doppler indices, newer methodologies designed to evaluate myocardial mechanics, such as two-dimensional speckle tracking echocardiography (2DSTE), provide additional diagnostic and clinical information in the context of CP. Research has demonstrated that cardiac mechanics can improve echocardiographic diagnostic accuracy of CP and aid in differentiating between constrictive and restrictive ventricular physiology...
August 19, 2016: Echocardiography
Qingqiang Ni, Lin Yun, Rui Xu, Guohua Li, Yucai Yao, Jiamin Li
Classic constrictive pericarditis (CP) is characterized by fibrous scarring and adhesion of both the visceral pericardium and the parietal pericardium, which leads to restricted cardiac filling. However, diagnosing CP with normal thickness pericardium and without calcification is still a challenge. The predominant cause in the developed world is idiopathic or viral pericarditis followed by post-cardiac surgery and post-radiation. Tuberculosis still remains a common cause of CP in developing countries. In this report, we describe a rare case of idiopathic localized constrictive visceral pericardium with normal thickness of the parietal pericardium in a middle-aged man...
September 2016: Frontiers of Medicine
Ikuo Misumi, Kenji Ebihara, Ryuichiro Akahoshi, Taku Rokutanda, Masafumi Miyajima, Toshihiro Esaki, Mitsuhiro Matsumoto, Yoshihiko Hirota, Hisao Ogawa
We present herein the case of a 72-year-old man who presented with orthopnea and was diagnosed with cardiac tamponade due to carcinomatous pericarditis. Pulsed Doppler echocardiogram showed prominent isovolumic relaxation flow (IVRF) directed from the cardiac base toward the apex. Such flow is rare in pericardial effusion and may be due to enhanced early diastolic untwisting, sphericalization of apex, and restriction of wall motion by epicardial fibrous tissue. We describe herein a rare case of prominent IVRF with interesting underlying mechanisms...
December 2011: Journal of Echocardiography
Partho P Sengupta, Yen-Min Huang, Manish Bansal, Ali Ashrafi, Matt Fisher, Khader Shameer, Walt Gall, Joel T Dudley
BACKGROUND: Associating a patient's profile with the memories of prototypical patients built through previous repeat clinical experience is a key process in clinical judgment. We hypothesized that a similar process using a cognitive computing tool would be well suited for learning and recalling multidimensional attributes of speckle tracking echocardiography data sets derived from patients with known constrictive pericarditis and restrictive cardiomyopathy. METHODS AND RESULTS: Clinical and echocardiographic data of 50 patients with constrictive pericarditis and 44 with restrictive cardiomyopathy were used for developing an associative memory classifier-based machine-learning algorithm...
June 2016: Circulation. Cardiovascular Imaging
Gaurav Chand, Ruby Jhaj, Kumar Sanam, Prabhat Sinha, Patrick Alexander
INTRODUCTION: Non-typhoidal Salmonella (NTS) is mostly restricted to gastroenteritis; however, we report a case of Salmonella pericarditis complicated by tamponade and spontaneous ventricular wall rupture. CASE PRESENTATION: A 67-year-old male presents to the Emergency Department with complaints of fevers, chills and body aches. A chest radiograph displayed an infiltrate and an electrocardiogram suggested acute pericarditis. An echocardiogram revealed a small pericardial effusion without tamponade...
May 2016: Annals of Medicine and Surgery
Mario J Garcia
About one-half of the patients with congestive heart failure have preserved left ventricular ejection fraction (HFpEF). Although the etiology of HFpEF is most commonly related to long-standing hypertension and atherosclerosis, a significant number of suspected HFpEF patients have a restrictive cardiomyopathy or chronic pericardial disease. Recognizing these syndromes is important because early diagnosis may lead to instituting specific therapy that may prolong survival, improve quality of life, and/or recognize and treat an underlying systemic disorder...
May 3, 2016: Journal of the American College of Cardiology
Massimo Imazio, Yehuda Adler, Philippe Charron
Recurrent pericarditis is one of the most troublesome complications of pericarditis occurring in about one third of patients with a previous attack of pericarditis. The pathogenesis is presumed to be autoimmune and/or autoinflammatory in most cases. The mainstay of therapy for recurrences is physical restriction and anti-inflammatory therapy based on aspirin or NSAID plus colchicine. Corticosteroids at low to moderate doses (e.g., prednisone 0.2 to 0.5 mg/kg/day) should be considered only after failure of aspirin/NSAID (and more than one of these drugs) or for specific indications (e...
June 2016: Current Cardiology Reports
Bruno Pinamonti, Sara Habjan, Antonio De Luca, Alberto Proclemer, Gaetano Morea, Elena Abate, Giancarlo Vitrella, Gianfranco Sinagra
Constrictive pericarditis is a rare pericardial disorder that causes an impairment of cardiac filling and frequently heart failure. The clinical presentation is non-specific and the differential diagnosis includes myocardial diseases, particularly restrictive cardiomyopathy. Echocardiography has a central role in the initial diagnosis. Some peculiar signs, such as abnormal inspiratory shift of the interventricular septum, increased respiratory variations of transmitral, transtricuspid and hepatic vein flow velocities and the normality of early diastolic relaxation velocity (e') at tissue Doppler, increase the likelihood of the disease...
March 2016: Giornale Italiano di Cardiologia
N Fujitsuka, A Asakawa, A Morinaga, M S Amitani, H Amitani, G Katsuura, Y Sawada, Y Sudo, Y Uezono, E Mochiki, I Sakata, T Sakai, K Hanazaki, T Yada, K Yakabi, E Sakuma, T Ueki, A Niijima, K Nakagawa, N Okubo, H Takeda, M Asaka, A Inui
Caloric restriction (CR) is known to retard aging and delay functional decline as well as the onset of diseases in most organisms. Ghrelin is secreted from the stomach in response to CR and regulates energy metabolism. We hypothesized that in CR ghrelin has a role in protecting aging-related diseases. We examined the physiological mechanisms underlying the ghrelin system during the aging process in three mouse strains with different genetic and biochemical backgrounds as animal models of accelerated or normal human aging...
February 2, 2016: Molecular Psychiatry
Gary Tse, Aamir Ali, Francisco Alpendurada, Sanjay Prasad, Claire E Raphael, Vassilis Vassiliou
INTRODUCTION: Constrictive pericarditis is characterized by constriction of the heart secondary to pericardial inflammation. Cardiovascular magnetic resonance (CMR) imaging is useful imaging modality for addressing the challenges of confirming this diagnosis. It can be used to exclude other causes of right heart failure, such as pulmonary hypertension or myocardial infarction, determine whether the pericardium is causing constriction and differentiate it from restrictive cardiomyopathy, which also causes impaired cardiac filling...
November 2015: Research in Cardiovascular Medicine
Ayanda Trevor Mnguni, Mark E Engel, Megan S Borkum, Bongani M Mayosi
BACKGROUND: Tuberculous pericardial effusion is a pro-fibrotic condition that is complicated by constrictive pericarditis in 4% to 8% of cases. N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) is a ubiquitous tetrapeptide with anti-fibrotic properties that is low in tuberculous pericardial effusion, thus providing a potential mechanism for the heightened fibrotic state. Angiotensin-converting enzyme inhibitors (ACE-I), which increase Ac-SDKP levels with anti-fibrotic effects in animal models, are candidate drugs for preventing constrictive pericarditis if they can be shown to have similar effects on Ac-SDKP and fibrosis in human tissues...
2015: PloS One
Massimo Imazio, Fiorenzo Gaita, Martin LeWinter
IMPORTANCE: Pericarditis is the most common form of pericardial disease and a relatively common cause of chest pain. OBJECTIVE: To summarize published evidence on the causes, diagnosis, therapy, prevention, and prognosis of pericarditis. EVIDENCE REVIEW: A literature search of BioMedCentral, Google Scholar, MEDLINE, Scopus, and the Cochrane Database of Systematic Reviews was performed for human studies without language restriction from January 1, 1990, to August 31, 2015...
October 13, 2015: JAMA: the Journal of the American Medical Association
Lois J Starr, Dorothy K Grange, Jeffrey W Delaney, Anji T Yetman, James M Hammel, Jennifer N Sanmann, Deborah A Perry, G Bradley Schaefer, Ann Haskins Olney
Myhre syndrome, a connective tissue disorder characterized by deafness, restricted joint movement, compact body habitus, and distinctive craniofacial and skeletal features, is caused by heterozygous mutations in SMAD4. Cardiac manifestations reported to date have included patent ductus arteriosus, septal defects, aortic coarctation and pericarditis. We present five previously unreported patients with Myhre syndrome. Despite varied clinical phenotypes all had significant cardiac and/or pulmonary pathology and abnormal wound healing...
December 2015: American Journal of Medical Genetics. Part A
Shuang Liu, Chunyan Ma, Weidong Ren, Jing Zhang, Nan Li, Jun Yang, Yan Zhang, Wei Qiao
Left atrial (LA) function plays an important role in the maintenance of cardiac output. However, whether assessment of regional LA myocardial dysfunction is useful for differentiating between CP and restrictive cardiomyopathy (RCM) remains unclear. Thirty-five patients with CP, 30 patients with RCM, and 30 healthy volunteers (controls) were enrolled in this study. The LA maximum volume (Vmax), LA minimal volume (Vmin), and LA volume before atrial contraction (Vpre-a) were measured using the biplane modified Simpson's rule...
December 2015: International Journal of Cardiovascular Imaging
Saeko Kushida, Naoki Takekawa, Takuya Mimura, Hidetaka Tsumura, Takeshi Sakamoto, Kazutoshi Tobimatsu, Ikuya Miki, Yoshinobu Yamamoto, Masahiro Tsuda, Hideto Inokuchi
A 61-year-old female was admitted to our hospital for esophageal cancer treatment. Esophagectomy with 2-field lymphadenectomy was performed. Postoperative findings revealed the lesion was a poorly differentiated squamous cell carcinoma invading into the diaphragm and there were no carcinoma cells on the surgical margins. Eight months after surgery, a recurrence was suspected by the presence of tumors at the pericardia, right axillary lymph node and around the descending aorta. The patient was re-admitted for chemotherapy and administrated fluorouracil and cisplatin 4 days after admission...
June 2014: Clinical Journal of Gastroenterology
Shrenik Doshi, Sivasubramanian Ramakrishnan, Saurabh Kumar Gupta
Cardiac catheterization and hemodynamic study is the gold standard for the diagnosis of pericardial constriction. Careful interpretation of the hemodynamic data is essential to differentiate it from other diseases with restrictive physiology. In this hemodynamic review we shall briefly discuss the physiologic basis of various hemodynamic changes seen in a patient with constrictive pericarditis.
March 2015: Indian Heart Journal
Jomien M Mouton, Adriano S Pellizzon, Althea Goosen, Craig J Kinnear, Philip G Herbst, Paul A Brink, Johanna C Moolman-Smook
INTRODUCTION: The minimum criterion for the diagnosis of hypertrophic cardiomyopathy (HCM) is thickening of the left ventricular wall, typically in an asymmetrical or focal fashion, and it requires no functional deficit. Using this criterion, we identified a family with four affected individuals and a single unrelated individual essentially with restrictive cardiomyopathy (RCM). Mutations in genes coding for the thin filaments of cardiac muscle have been described in RCM and HCM with 'restrictive features'...
March 2015: Cardiovascular Journal of Africa
Neeraj Parakh, Sameer Mehrotra, Sandeep Seth, S Ramakrishnan, Shyam S Kothari, Balram Bhargava, V K Bahl
BACKGROUND: The differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) may be clinically difficult and may require multiple investigations. Even though brain natriuretic peptide (BNP) is shown to be higher in patients with RCM as compared to CP, the clinical utility is not fully established especially in Indian patients known to have advanced CP and myocardial involvement. METHODS AND RESULTS: We measured NT-pro-BNP levels in 49 patients suspected of having either CP or RCM, diagnosed on the basis of echocardiography, computed tomography, magnetic resonance imaging, endomyocardial biopsy and cardiac catheterization data as needed...
January 2015: Indian Heart Journal
Veljko Flego, Dubravka Matanić Lender, Ljiljana Bulat-Kardum
Tuberculosis (TB) is an infectious disease and, apart from protecting patients, attention must be given to protecting the persons who come in contact with them, especially nurses and medical practitioners. A 43-year-old immunocompetent male nurse developed occupationally disseminated TB after contact with patients affected by active TB (culture positive) while working in a psychiatric hospital. The first manifestation of the disease was exudative pericarditis with Mycobacterium tuberculosis (MT) confirmed two months after pericardiocentesis and evacuation of 1200 mL of pericardial effusion...
December 2014: Arhiv za Higijenu Rada i Toksikologiju
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