Abstract: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 remissio… Show more
“…In the last two decades, the evolution of non-invasive imaging examinations have facilitated the early recognition of Constrictive Pericarditis, with chest tomography having the highest specificity to show calcification and magnetic resonance imaging being the gold standard in the diagnosis of constrictive physiology, where it shows a thickening of the pericardium and dynamic abnormalities related to diastolic dysfunction. (GODOY et al, 2007).…”
The pericardium is a fibrous membrane that surrounds the heart and is composed of two components: visceral pericardium and parietal pericardium. Under physiological conditions, it performs important functions, such as lubrication, which minimizes friction between the organ and adjacent structures, limits intrathoracic cardiac motion, aids in filling the cardiac chambers, and participates in the balancing between the right and left ventricles during diastole and systole interactions. Constrictive Pericarditis occurs when the pericardium is thickened, fibrotic and often calcified, significantly reducing its compliance and preventing adequate cardiac filling during diastole. This is a relatively rare condition, with varied causes. The main cause is idiopathic, followed by involvement after heart surgery or radiotherapy, and also - especially in developing countries - of infectious and parasitic etiology, especially tuberculosis. The diagnosis is often challenging, since this disease typically presents with insidious and chronic symptoms, predominantly with systemic venous congestion, mimicking other disorders such as restrictive cardiomyopathy. In the last two decades, the evolution of noninvasive imaging examinations have facilitated the early recognition of Constrictive Pericarditis. Echocardiogram (transthoracic and transesophageal), central and transvalvular pressure Doppler measurements, Magnetic Resonance Imaging and Catheterization are the main exams of choice for the diagnosis. Although drug treatment alleviates the symptoms of heart failure, severe cases may require pericardiotomy.
“…In the last two decades, the evolution of non-invasive imaging examinations have facilitated the early recognition of Constrictive Pericarditis, with chest tomography having the highest specificity to show calcification and magnetic resonance imaging being the gold standard in the diagnosis of constrictive physiology, where it shows a thickening of the pericardium and dynamic abnormalities related to diastolic dysfunction. (GODOY et al, 2007).…”
The pericardium is a fibrous membrane that surrounds the heart and is composed of two components: visceral pericardium and parietal pericardium. Under physiological conditions, it performs important functions, such as lubrication, which minimizes friction between the organ and adjacent structures, limits intrathoracic cardiac motion, aids in filling the cardiac chambers, and participates in the balancing between the right and left ventricles during diastole and systole interactions. Constrictive Pericarditis occurs when the pericardium is thickened, fibrotic and often calcified, significantly reducing its compliance and preventing adequate cardiac filling during diastole. This is a relatively rare condition, with varied causes. The main cause is idiopathic, followed by involvement after heart surgery or radiotherapy, and also - especially in developing countries - of infectious and parasitic etiology, especially tuberculosis. The diagnosis is often challenging, since this disease typically presents with insidious and chronic symptoms, predominantly with systemic venous congestion, mimicking other disorders such as restrictive cardiomyopathy. In the last two decades, the evolution of noninvasive imaging examinations have facilitated the early recognition of Constrictive Pericarditis. Echocardiogram (transthoracic and transesophageal), central and transvalvular pressure Doppler measurements, Magnetic Resonance Imaging and Catheterization are the main exams of choice for the diagnosis. Although drug treatment alleviates the symptoms of heart failure, severe cases may require pericardiotomy.
“…A RNM mostra um espessamento do pericárdio e anomalias dinâmicas relacionadas a disfunção diastólica. (GODOY et al, 2007). Esta é mais específica para a detecção de inflamação ativa, auxiliando na identificação de pacientes candidatos a tratamento clinico com antiinflamatorios.…”
A pericardite constritiva se desenvolve a partir de um espessamento fibroso do pericárdio, sendo o estágio final de um processo inflamatório que envolve suas diferentes camadas. Resulta em restrição de enchimento de todas as câmaras cardíacas refletindo em quadro de insuficiência cardíaca. Relata-se um caso de pericardite constritiva secundária a manipulação cirúrgica prévia em região de mediastino anterior após timectomia.
“…Na PC comumente encontram-se elevações leves na creatinina e enzimas hepáticas (em particular fosfatase alcalina), baixa voltagem do complexo QRS no ECG, Fibrilação Atrial (em 30% dos casos), nível sérico de albumina normal (nos casos de ascite por IC sem cirrose) 9,10,14,16 , parâmetros presentes no caso exposto.…”
Section: Relato Do Casounclassified
“…O quadro clínico manifesta-se com sinais e sintomas de IC direita, pressão venosa sistêmica elevada (turgência de veia jugular, ascite, hepatomegalia, edema periférico), sinais de baixo débito cardíaco e ausculta pulmonar sem congestão 2 . É com frequência confundida com outras patologias, sendo muitas vezes diagnosticada erroneamente como Doença Hepática Crônica 9 .…”
INTRODUÇÃO: A Pericardite Constritiva (PC) é uma causa de Insuficiência Cardíaca (IC) Restritiva onde ocorre comprometimento do enchimento cardíaco decorrente do processo cicatricial de pericardite prévia que torna o pericárdio espessado, calcificado, aderido e inelástico. Deve ser considerada no diagnóstico diferencial de insuficiência cardíaca de etiologia indefinida especialmente nos casos em que a fração de ejeção do ventrículo esquerdo (VE) é preservada. É com frequência confundida com outras patologias, sendo muitas vezes diagnosticada erroneamente como doença hepática crônica. OBJETIVO: relatar o caso de uma paciente em investigação de hepatopatia crônica e posteriormente foi finalmente diagnosticada com PC. CASO CLÍNICO: Paciente feminina, 49 anos, sem antecedentes pessoais prévios. Negava etilismo e tabagismo. Estava em investigação de ascite, edema de membros inferiores e dispneia aos esforços habituais. Ao exame físico apresentava turgência jugular e edema de membros inferiores além de ascite. Apresentou ecografia normal no início da investigação,
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