Effusive-Constrictive Pericarditis in a Young Active Duty Male

Abstract

Effusive-constrictive pericarditis (ECP) is a rare clinical entity resulting from accumulating pericardial fluid within a stiff, non-compliant pericardium. There are a number of etiologies for ECP, which include malignancy, radiation, post-surgical causes, infectious, and collagen disorders. Clinically, ECP often presents as right-sided heart failure, or in advanced cases, cardiac tamponade. Symptoms may persist despite treatment with pericardiocentesis, and may warrant consideration for pericardiectomy for more definitive management. Invasive hemodynamic evaluation with cardiac catheterization remains the gold standard for diagnosis of ECP; however, echocardiography can provide a definitive diagnosis with high sensitivity and specificity. Echocardiographic features suggestive of ECP include ventricular septal motion abnormalities, such as interdependence, accentuated longitudinal motion of the heart, and altered respirophasic ventricular filling. While these features have been well established and can lead to the diagnosis of ECP, they are rarely observed in clinical practice. We present a case of ECP in a 25-year-old active duty male with a history of chest wall myoepithelial carcinoma who clearly demonstrated such echocardiographic findings of ECP.

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

“…Echocardiography can provide a potential non-invasive diagnostic tool with high sensitivity and specificity, which shows the coexistence of effusive and constrictive pericardial features[ 2 ]. Identification of ECP using echocardiography requires comprehensive observation with 2D, Doppler, and M-mode echocardiography[ 7 ]. 2D imaging has an excellent ability to detect effusion, enlarged atrial size, interventricular septum bounce, and a dilated IVC, which are sensitive and specific signs for the initial diagnosis of ECP.…”

“…The key characteristic performance features of ECP include “annulus reversus,” restrictive mitral inflow (E/A > 2), greater than 25% respiratory variation in the peak mitral inflow velocity (E)[ 10 ]. The M-mode echocardiography can demonstrate a persistently dilated IVC and the posterior motion of the septum during early diastole on inspiration[ 7 , 11 ], providing additional diagnostic information. In the present case, echocardiographic signs of pericardial effusion were observed during the initial examination.…”

Acute Fibrinous Constrictive Pericarditis and Large Pericardial Effusion as The First Manifestation of Systemic Lupus Erythematous Disease in an Adult Male Patient

“…Pericardial syndromes are not uncommon manifestations in clinical practice [1]. About 5% of all patients admitted to the emergency department with the chief complaint of chest pain, are diagnosed with acute pericarditis [2].…”

Acute fibrinous constrictive pericarditis and large pericardial effusion as the first manifestation of systemic lupus erythematsous disease in an adult male patient

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Pericardial syndromes are not uncommon manifestations in clinical practice. 1 About 5% of all patients admitted to the emergency department with the chief complaint of chest pain, are diagnosed with acute pericarditis. 2 Cardiac involvement is a common presentation of different autoimmune rheumatic diseases.

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