A 63‐Year‐Old Woman with a Pericardial Effusion, Bilateral Pleural Effusions, and Ascites: Is the Whole Greater than the Sum of Its Parts?

Sparano, Dina M.; Kohli, Priya; Gulati, Martha

doi:10.1111/j.1540-8175.2009.01110.x

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…Treatment often involves catheter-based fluid drainage and supportive therapy. If refractory constrictive physiology, a visceral pericardiectomy is curative; however this is a technically challenging surgery that requires sharp, precise dissection and should only be done by experienced surgeons [28]. & It should be noted that constrictive physiology as determined on echocardiography frequently persists for a few days to a few weeks after pericardiocentesis for cardiac tamponade.…”

Section: Constrictive Pericarditismentioning

confidence: 99%

Pericarditis and Pericardial Effusion: Management Update

Sparano

Ward

2011

Curr Treat Options Cardio Med

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Prompt recognition of the signs and symptoms of pericardial disease is critical so that appropriate treatments can be initiated. Acute pericarditis has a classical presentation, including symptoms, physical examination findings, and electrocardiography abnormalities. Early recognition of acute pericarditis will avoid unnecessary invasive testing and prompt therapies that provide rapid symptom relief. Non-steroidal anti-inflammatory drugs (NSAIDs) remain first-line therapy for uncomplicated acute pericarditis, although colchicine can be used concomitantly with NSAIDS as the first-line approach, particularly in severely symptomatic cases. Colchicine should be used in all refractory cases and as initial therapy in all recurrences. Aspirin should replace NSAIDS in pericarditis complicating acute myocardial infarction. Systemic corticosteroids can be used in refractory cases or in those with immune-mediated etiologies, although generally should be avoided due to a higher risk of recurrence. Pericardial effusions have many etiologies and the approach to diagnosis and therapy depends on clinical presentation. Pericardial tamponade is a life-threatening clinical diagnosis made on physical examination and supported by characteristic findings on diagnostic testing. Prompt diagnosis and management is critical. Treatment consists of urgent pericardial fluid drainage with a pericardial drain left in place for several days to help prevent acute recurrence. Analysis of pericardial fluid should be performed in all cases as it may provide clues to etiology. Consultation of cardiac surgery for pericardial window should be considered in recurrent cases and may be the first-line approach to malignant effusions, although acute relief of hemodynamic compromise must not be delayed. Constrictive pericarditis is associated with symptoms that mimic many other cardiac conditions. Thus, correct diagnosis is critical and involves identification of pericardial thickening or calcification in association with characteristic hemodynamic alterations using noninvasive and invasive diagnostic approaches. Constrictive physiology may occur transiently and resolve with medical therapy. In chronic cases, definitive therapy requires referral to an experienced surgeon for pericardiectomy.

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Section: Constrictive Pericarditismentioning

confidence: 99%

Pericarditis and Pericardial Effusion: Management Update

Sparano

Ward

2011

Curr Treat Options Cardio Med

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A Girl With Right Heart Failure Related to Effusive-Constrictive Pericarditis

Chen

et al. 2011

Pediatr Cardiol

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Effusive-constrictive pericarditis is characterized by constriction of visceral pericardium with a coexisting tense pericardial effusion. We report a 10-year-old girl with right heart failure due to effusive-constrictive pericarditis. She did not present typical features, such as cardiac tamponade or thickening of pericardium (visceral and parietal), but constrictive physiology was observed by echocardiography and cardiac computed tomography. These noninvasive imaging modalities provided clinical clues to make precise diagnosis. The patient underwent surgical drainage of pericardial fluid and visceral pericardiectomy, which resulted in improved hemodynamics and symptoms.

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