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differentiating constrictive pericarditis and

Maria Carmo P Nunes, Milton Henriques Guimarães Júnior, Adriana Costa Diamantino, Claudio Leo Gelape, Teresa Cristina Abreu Ferrari
The heart may be affected directly or indirectly by a variety of protozoa and helminths. This involvement may manifest in different ways, but the syndromes resulting from impairment of the myocardium and pericardium are the most frequent. The myocardium may be invaded by parasites that trigger local inflammatory response with subsequent myocarditis or cardiomyopathy, as occurs in Chagas disease, African trypanosomiasis, toxoplasmosis, trichinellosis and infection with free-living amoebae. In amoebiasis and echinococcosis, the pericardium is the structure most frequently involved with consequent pericardial effusion, acute pericarditis, cardiac tamponade or constrictive pericarditis...
May 2017: Heart: Official Journal of the British Cardiac Society
Shane Patrick Flood, Omar Ayah, Satoshi Furukawa, Robert B Norris
A 67-year-old man presented with 3 months of exertional dyspnoea and 1 week of oedema. Examination revealed elevated neck veins, pulsus paradoxus, muffled heart sounds, decreased breath sounds and pedal oedema. Transthoracic echocardiogram (TTE) demonstrated cardiac tamponade, and chest X-ray showed pleural effusion. Pericardiocentesis, thoracocentesis, laboratory investigations and CT did not elucidate an underlying aetiology. Three weeks later, he presented with recurrent cardiac tamponade and pleural effusion...
January 18, 2017: BMJ Case Reports
Jeffrey B Geske, Nandan S Anavekar, Rick A Nishimura, Jae K Oh, Bernard J Gersh
Differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) is a complex and often challenging process. Because CP is a potentially curable cause of heart failure and therapeutic options for RCM are limited, distinction of these 2 conditions is critical. Although different in regard to etiology, prognosis, and treatment, CP and RCM share a common clinical presentation of predominantly right-sided heart failure, in the absence of significant left ventricular systolic dysfunction or valve disease, due to impaired ventricular diastolic filling...
November 29, 2016: Journal of the American College of Cardiology
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...
October 2016: 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
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
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
Joanna Ścieszka, Józefa Dąbek, Paweł Cieślik
We report a case of a 17-year-old patient referred to our outpatient Doppler Department due to clinical suspicion of liver cirrhosis. The patient presented with non-specific symptoms, such as malaise, pain in the right subcostal region, peripheral oedema. Until then, diagnostic imaging, including echocardiography was inconclusive. We performed the Doppler sonography of the portal system, which revealed normal diameter of the portal vein with abnormal, phasic and markedly pulsatile waveform. Hepatic veins distention with pathological reverse flow during systole was reported...
June 2015: Journal of Ultrasonography
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
Gonçalo Filipe Domingos Nunes, Narcisa Fatela, Fernando Ramalho
Constrictive pericarditis (CP) is an uncommon disease resulting from chronic pericardial inflammation, fibrosis and calcification. Once there are atypical forms of presentation, with subtle or nonexistent cardiorespiratory symptoms, diagnosis may be challenging and difficult. Recurrent ascites in patients with congestive hepatopathy due to constrictive pericarditis is common and, in most cases, reversible after pericardiectomy. Nevertheless, development of persistent liver dysfunction may be a long-term complication...
June 2016: Revista Española de Enfermedades Digestivas
Zurabi Lominadze, Leila Kia, Sanjiv Shah, Keyur Parekh, Josh Levitsky
We report a 43-year-old man who presented for evaluation of ascites, varices, and hepatosplenomegaly. Initial labs were notable for normal platelets, mild liver synthetic dysfunction, and disproportionately elevated alkaline phosphatase. He was presumed to have underlying cirrhosis, and diuresis was attempted without success. A transjugular liver biopsy showed marked sinusoidal dilation without cirrhosis. Diagnostic paracentesis revealed fluid studies suggestive of cardiac ascites. Further cardiac evaluation confirmed constrictive pericarditis...
April 2015: ACG Case Reports Journal
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
O L Bockeriia, I I Averina
Key factors defining the prognosis of patients with heart failure (HF) are cardiac remodeling and myocardial contractility. New methods of visualization of myocardial motion gave impulse to research in the area of heart physiology and pathology. However in clinical practice these methods are still rarely used. Evaluation of systolic and diastolic functions based on tissue Doppler (TD), 2D and 3D speckle tracking data provides information on the pressure of left ventricular (LV) filling and enables carrying out differential diagnosis between constrictive pericarditis and myocardial diseases with diastolic dysfunction, dyspnea caused by cardiac and extracardiac causes...
2015: Kardiologiia
Giovanni Donato Aquaro, Andrea Barison, Alessandro Cagnolo, Giancarlo Todiere, Massimo Lombardi, Michele Emdin
Cardiac Magnetic Resonance (CMR) allows evaluation of the functional and flow changes in pericardial constriction as well as detection of acute pericardial inflammation, fusion and thickening of pericardial layers and pericardial effusion. We sought to evaluate the diagnostic role of tissue characterization by CMR in constrictive pericarditis (CP). We performed a CMR exam in 70 patients (mean age 58 ± 16) with clinical suspicion of constrictive pericarditis and constrictive pattern at echocardiography and/or catheterization...
June 2015: International Journal of Cardiovascular Imaging
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
I Vasile, M Negulescu, G Florescu, R Ionescu, S Berbecaru
This presentation calls attention to the many problems involved in the positive, aetiological and differential diagnosis of chronic constrictive pericarditis. We mention the difficulties in aetiological diagnosis in the absence of an episode of acute pericarditis in the past medical history and the clinical findings similar to vascular decompensated cirrhosis or idiopathic restrictive cardiomyopathy. ECG and two-dimensional echocardiography do not have an important role in diagnosis, and in the absence of computed tomography and magnetic resonance imaging, chest radiography, especially a lateral view, could establish the diagnosis...
December 2004: Netherlands Heart Journal
M Veil-Picard, G Rival, B Aupècle, F Laluc, J Maitre, M-F Seronde, J-C Dalphin
INTRODUCTION: Constrictive pericarditis is associated with thickening, fibrosis or inflammation of the pericardium which can lead to signs of right ventricle dysfunction. It is usually a chronic process which can present in a variety of ways. We present two cases of constrictive pericarditis discovered during the investigation of a left-sided pleural effusion. OBSERVATION: The cases represent two sorts of constrictive pericarditis, chronic and due to pericardial effusions...
January 2015: Revue des Maladies Respiratoires
Lidia Ziółkowska, Mateusz Śpiewak, Łukasz Małek, Agnieszka Boruc, Wanda Kawalec
BACKGROUND: Cardiovascular magnetic resonance (CMR) imaging is a clinically proven and reliable diagnostic method for the assessment of morphology, function, and characteristics of myocardial tissue in patients with myocardial diseases. The use of gadolinium contrast agents has created new diagnostic possibilities for tissue characterisation in patients with suspected or known cardiomyopathy, myocarditis, and cardiac tumours. AIM: To evaluate the usefulness of CMR in the diagnostic process in children with myocardial diseases and to compare the results of CMR and other non-invasive cardiovascular methods, including echocardiography...
2015: Kardiologia Polska
Daniel Erlij, Daniel Ramos, Jacqueline Montaña, Paula Kusnir, Gonzalo Correa, Oscar Neira
Due to its multisystem involvement, IgG4 -related disease should be considered in the differential diagnosis of medical conditions such as lymphadenopathies, aortitis, serositis and retroperitoneal fibrosis. It shares features with other entities historically described as "great mimickers" such as syphilis, tuberculosis, sarcoidosis, and systemic lupus erythematosus. We report a 40 year-old male with recurrent effusive - constrictive pericarditis, lymphadenopathy and aortitis. The study revealed an inactive tuberculosis with negative cultures for acid fast bacilli...
May 2014: Revista Médica de Chile
Amir M Nia, R-J Schulz, E Erdmann
No abstract text is available yet for this article.
November 2014: Deutsche Medizinische Wochenschrift
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