SummaryA 55-year-old male patient with a 10 year history of hemodialysis was admitted for examination of pericardial effusion. Specific echocardiography, MRI, and cardiac catheterization findings strongly suggested a diagnosis of effusive constrictive pericarditis. Pericardiectomy showed the following distinct findings. Two layers of fibrous tissue below the thickened pericardium emerged. The cardiac constriction had not been relieved until the inner layer was partially resected. We conclude that patients in dialysis associated constrictive pericarditis should undergo pericardiectomy before the adhesion between fibrous tissues becomes hard. Case ReportThe patient was a 55 year-old male. He had been started on maintenance hemodialysis due to chronic glomerulonephritis 10 years earlier. Moderate inflammatory reaction with C-reactive protein of 6.8 mg/dL was detected in 2008 in a dialysis clinic. Chest computer tomography revealed mild pericardial effusion and bilateral pleural effusion. Therefore, even intensive dialysis for one month could not remove the effusion or improve the inflammatory reaction. He was referred to our hospital due to the refractory pericardial effusion.His blood pressure was 101/66 mmHg, the pulse rate was 84 beats per minute, and the oxygen saturation was 98%. Auscultation of the chest revealed no apparent abnormalities, including knock sound. Neither jugular venous distention nor pretibial pitting edema was present. Laboratory findings on admisFrom the
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