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Revista chilena de cardiología

versión On-line ISSN 0718-8560

Resumen

VEGA, Julián et al. Constrictive Pericarditis. Always a diagnostic challenge. Rev Chil Cardiol [online]. 2016, vol.35, n.3, pp.255-261. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602016000300007.

We report the case of a 52 y.o. male, with longstanding history of chest pain. Coronariography performed in 2005 showed normal coronary arteries. In the following years he developed progressive abdominal bloating and pain, upper gastrointestinal endoscopy was normal, but atrial fibrillation was diagnosed initiating therapy. During the year 2016 symptoms got worse, being admitted to our hospital. Echocardiography revealed severe biatrial enlargement, preserved bi-ventricular function, and a paradoxical bouncing motion of the interventricular septum which augmented during inspiration (septal bounce). The pericardium was thickened with absence of normal sliding between its layers, and traction of adjacent soft tissues was observed. Mitral ring tissue Doppler showed reversal of lateral and medial e' velocities. Inferior vena cava was dilated with no respiratory variation. Cardiac catheterization was consistent with constrictive pericarditis. Computed tomography confirm extensive pericardial calcification and thickness and found signs of chronic liver disease. Uneventful pericardiectomy was performed, intraoperative and histological findings confirm the diagnostic of calcified pericardial constriction, being discharged on the fifth day post-surgery.

Palabras clave : Pericarditis; Constrictive; Heart failure; Pericardiectomy.

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