A rare cause of effusive–constrictive pericarditis

Abstract

Effusive-constrictive pericarditis (ECP) is an uncommon diagnosis, frequently missed due to its heterogeneous presentation, but a potentially reversible cause of heart failure. A 62-year-old Caucasian male presented with remittent right heart failure and mild-moderate pericardial effusion. Following an initial diagnosis of idiopathic pericarditis, indomethacin was started, but the patient shortly relapsed, presenting with severe pericardial effusion and signs of cardiac tamponade, requiring pericardiocentesis. ECP was diagnosed on cardiac catheterization. Cardiac computed tomography showed non-calcified, mildly thickened and inflamed parietal pericardium. Pericardiectomy was performed with symptoms remission. On histological examination of pericardium, chronic non-necrotizing granulomatous inflammation was noted. Polymerase chain reaction assay was positive for non-tuberculous mycobacteria. This case represents a rare finding of ECP with unusual presentation due to atypical mycobacteriosis in a non-immunocompromised patient and in a non-endemic area. Pericardiectomy can be an effective option in cases unresponsive to anti-inflammatory treatment, even in the absence of significant pericardial thickening or calcification.

Non-calcified constrictive pericarditis; Two Case Reports

“…At present, it is believed that for patients highly suspected of constrictive pericarditis, right ventricular catheter oating test is feasible, and if necessary, surgical thoracotomy is feasible. For patients with clinically unexplained right heart failure and ascites, the possibility of constrictive pericarditis cannot be ignored while considering the causes such as cirrhosis 10,11 . In imaging evaluation, pericardial calci cation is not a necessary condition for the diagnosis of constrictive pericarditis, but it has great reference value, but not all pericardial calci cation can be diagnosed as constrictive pericarditis.…”

Pseudomonas aeruginosa-related effusive-constrictive pericarditis diagnosed with echocardiography: A case report

“…A comprehensive study with 2D imaging, Doppler, and M-mode echocardiography is required to avoid misdiagnosis. More importantly, for patients initially diagnosed with pericardial effusion, the echocardiographic features of constrictive pericarditis after pericardiocentesis should raise a suspicion of ECP[ 12 ]. Therefore, when a localized pericardial effusion is detected, follow-up echocardiographic examinations may assist in clinical diagnosis and treatment.…”

A Case of Pericarditis and Pericardial Masses Associated With Mycobacterium Paragordonae

“…There have been case reports describing NTM in association with pericarditis, however not specifically with M. paragordonae. 11 , 12 They have been described in cases of endocarditis (usually secondary to contaminated procedural equipment) 13 - 18 and less commonly in cases of pericarditis. 11 , 19 Furthermore, M. paragordonae pericarditis has never been documented.…”

“… 11 , 12 They have been described in cases of endocarditis (usually secondary to contaminated procedural equipment) 13 - 18 and less commonly in cases of pericarditis. 11 , 19 Furthermore, M. paragordonae pericarditis has never been documented. Here we describe the case of a patient with pericarditis and pericardial masses associated with M. paragordonae .…”