“…Catheterization of the right and left ventricles should be made to permit simultaneous measurement of the right and left heart filling pressures. Typical findings include an increase and balance (within 5 mmHg) of the diastolic pressures of the right atrium, right ventricle, left atrium (mean pulmonary capillary pressure) and diastolic pressure of the left ventricle [4]. Except that the left ventricle pressure, at the end of diastole, exceeds the right ventricle pressure by a few mmHg [1].…”
Section: Discussionmentioning
confidence: 99%
“…At electrocardiography, findings include low voltage QRS, inversion or generalized flattening of the T wave and left atrial abnormalities suggestive of P mitral wave, atrioventricular and intraventricular blocks with widening of the QRS, right ventricular overload, with deviation of axis to the right [7,8]. The echocardiogram is very valuable in the evaluation of pericardial thickening, principally for calcification, however it can also show unspecific alterations [1,4,7]. The most sensitive examination to determine the pericardial thickness is the transesophageal echocardiogram [1].…”
Section: Discussionmentioning
confidence: 99%
“…In CCP, the diastolic filling is abnormally reflected in a characteristic curve with dips and plateaus of both ventricles [1,3,4]. The rapid elevation of pressure, after the initial diastolic dip, corresponds to a period of quick diastolic filling, while the plateau phase corresponds to the middle and late period of diastole, when there is little ventricle expansion.…”
Section: Discussionmentioning
confidence: 99%
“…Chronic Constrictive Pericarditis (CCP) is characterized by the presence of inflamed and fused thick fibrotic pericarditis, which restricts diastolic filling of the heart [1][2][3]. It is rare in children and the diagnosis is difficult to determine; the etiology in 60% of cases is not elucidated [4]. However, it is frequently confused with other diagnoses, such as chronic liver disease, restrictive cardiomyopathy and idiopathic cardiopathy [5].…”
A 55-year-old male patient presented in our service with progressive dyspnea and ascitis beginning 1 year and 8 months previously. He weighed 160 kg (normal weight 95 kg), with ascitis and orthopnea. On admission he presented normal echocardiograms. An electrocardiogram showed diffuse inverted T waves. An endomyocardial biopsy was not elucidative. A new echocardiogram confirmed a very thick pericardium. Surgical pericardial resection was indicated. The postoperative period was uneventful with complete remission of symptoms. The anatomopathological analysis was normal. The pericarditis was classified as idiopathic. This case is a warning for the need of much suspicion in patients with apparent causeless voluminous ascitis.
“…Catheterization of the right and left ventricles should be made to permit simultaneous measurement of the right and left heart filling pressures. Typical findings include an increase and balance (within 5 mmHg) of the diastolic pressures of the right atrium, right ventricle, left atrium (mean pulmonary capillary pressure) and diastolic pressure of the left ventricle [4]. Except that the left ventricle pressure, at the end of diastole, exceeds the right ventricle pressure by a few mmHg [1].…”
Section: Discussionmentioning
confidence: 99%
“…At electrocardiography, findings include low voltage QRS, inversion or generalized flattening of the T wave and left atrial abnormalities suggestive of P mitral wave, atrioventricular and intraventricular blocks with widening of the QRS, right ventricular overload, with deviation of axis to the right [7,8]. The echocardiogram is very valuable in the evaluation of pericardial thickening, principally for calcification, however it can also show unspecific alterations [1,4,7]. The most sensitive examination to determine the pericardial thickness is the transesophageal echocardiogram [1].…”
Section: Discussionmentioning
confidence: 99%
“…In CCP, the diastolic filling is abnormally reflected in a characteristic curve with dips and plateaus of both ventricles [1,3,4]. The rapid elevation of pressure, after the initial diastolic dip, corresponds to a period of quick diastolic filling, while the plateau phase corresponds to the middle and late period of diastole, when there is little ventricle expansion.…”
Section: Discussionmentioning
confidence: 99%
“…Chronic Constrictive Pericarditis (CCP) is characterized by the presence of inflamed and fused thick fibrotic pericarditis, which restricts diastolic filling of the heart [1][2][3]. It is rare in children and the diagnosis is difficult to determine; the etiology in 60% of cases is not elucidated [4]. However, it is frequently confused with other diagnoses, such as chronic liver disease, restrictive cardiomyopathy and idiopathic cardiopathy [5].…”
A 55-year-old male patient presented in our service with progressive dyspnea and ascitis beginning 1 year and 8 months previously. He weighed 160 kg (normal weight 95 kg), with ascitis and orthopnea. On admission he presented normal echocardiograms. An electrocardiogram showed diffuse inverted T waves. An endomyocardial biopsy was not elucidative. A new echocardiogram confirmed a very thick pericardium. Surgical pericardial resection was indicated. The postoperative period was uneventful with complete remission of symptoms. The anatomopathological analysis was normal. The pericarditis was classified as idiopathic. This case is a warning for the need of much suspicion in patients with apparent causeless voluminous ascitis.
“…Pericardial involvement in end-stage renal disease (ESRD) is manifested most commonly as acute uremic or dialysis pericarditis and infrequently as chronic constrictive pericarditis. The cause of 60% of cases of CCP is unknown and is labeled as idiopathic [1]. Moreover, CCP is commonly confused with other diagnoses such as end-stage-liver failure, idiopathic cardiomyopathy, and restrictive cardiomyopathy.…”
Pericardial involvement in end-stage renal disease (ESRD) is manifested most commonly as acute uremic or dialysis pericarditis and infrequently as chronic constrictive pericarditis (CCP). We report a 27-year-old patient with a history of uncontrolled hypertension, end-stage-renal disease on hemodialysis, who presented with recurrent ascites, dyspnea, and hypotension. After diagnosis with CCP, a partial pericardiectomy was performed; however, the patient did not improve and a salvage total pericardiectomy soon followed. He continued to decompensate and expired following a terminal extubation. No definitive cause of constrictive pericarditis was found. Nonetheless, we surmise it may have developed secondary to his end-stage renal disease. A literature review revealed end-stage kidney disease as a relatively uncommon cause of CCP; only a few other such associations have thus far been reported.
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