A case of pericardial constriction: diagnosis and treatment

Excerpt

We report the case of a 60 year old man, with previous history of pericardial Tuberculosis with partial pericardiectomy who came to the Cardiology Department complaining of progressive dyspnea, and presenting signs of right heart failure Chest X-ray showed a dense pericardial calcification on lateral and inferior walls of left ventricle (Fig. 1A). Transthoracic ecochardiogram revealed typical features of constrictive pericarditis as respiratory variation on doppler assesment and protodiastolic “nocht” of interventricular septum (Fig. 1B). Right ventricle was dilated and its function depressed. Computed tomography (CT) confirmed a calcified pericardium (Fig. 1C, D) and surgical treatment with partial resection was practised. At discharge, control echocardiogram still showed signs of constriction being patient in functional class III/IV. He was finally submitted for peritoneal dialysis as palliative treatment.

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