1/11. Echocardiographic findings in constrictive pericarditis. A case report.The echocardiographic findings in a 73-year-old woman with constrictive calcified pericarditis are presented. The diagnosis was confirmed by physical examination, chest x-rays and cardiac catheterization. The echocardiogram demonstrated abnormal motion of the interventricular septum and of the left ventricular posterior wall, multiple thickened echoes of the posterior pericardium, and a localized dense band of anterior pericardial echoes, which corresponded to the calcification seen on the chest X-ray.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/11. Constrictive pericarditis.The diagnosis of constrictive pericarditis remains a challenge because its physical findings and hemodynamics mimic restrictive cardiomyopathy. Various diagnostic advances over the years enable us to differentiate between these two conditions. This review begins with a case report of constrictive pericarditis, followed by a brief history and discussions of etiologies. Clinical features, radiologic, electrocardiographic, angiographic findings, and hemodynamics of constrictive pericarditis are reviewed. The echocardiographic findings are detailed and the recent advances in Doppler flow velocity patterns of pulmonary, mitral, tricuspid valves and hepatic veins are reported. Nuclear ventriculograms depict rapid ventricular filling in constrictive pericarditis and differentiate it from restrictive cardiomyopathy. Endomyocardial biopsy helps further in recognizing the various types of restrictive cardiomyopathies. Computed tomography and magnetic resonance imaging delineate abnormal pericardial thickness in constrictive pericarditis. association of characteristic hemodynamic changes and abnormal pericardial thickness > 3 mm usually confirms the diagnosis of constrictive pericarditis. Effusive and occult varieties of constrictive pericarditis are briefly described. This review concludes with emphasizing the importance of pericardial resection.- - - - - - - - - - ranking = 0.076701324087654keywords = physical (Clic here for more details about this article) |
3/11. Constrictive pericarditis presenting as massive ascites in children: report of one case.Abdominal distension has been described as the most common presenting symptom in children with constrictive pericarditis. This report describes a 13-year-old boy who had abdominal distension with massive ascite and hepatosplenomegaly as an initial presentation. The physical signs of jugular vein engorgement and gallop rhythm as well as the pericardial calcification on the chest roentgenogram lead to the diagnosis of constrictive pericarditis. After ultrafast computed tomography and cardiac catheterization confirmation, the patient received a pericardiectomy with excellent relief of symptoms. pathology of the pericardium reveals fibrocalcified change, but no acid fast stained bacillus nor granulomatous lesion was observed. The incidence of constrictive pericarditis with evident pericardial calcification in children is extremely low. The diagnostic value of the chest roentgenogram and physical findings for the constrictive pericarditis are addressed.- - - - - - - - - - ranking = 0.15340264817531keywords = physical (Clic here for more details about this article) |
4/11. Constrictive pericarditis with dwarfism in two siblings (mulibrey nanism).Two siblings with marked dwarfism, now 11 and 19 years of age, have been followed from infancy. The girl had frequent episodes of pneumonitis and presented at age 4 years with hepatic enlargement and ascites which proved to be due to constrictive pericarditis. The boy presented with growth failure and pseudohydrocephalus. He had fibrous dysplasia of the tibia and a pathologic fracture; acute hepatic congestion followed physical activity at age 13 years and led to the diagnosis of constrictive pericarditis. Muscle function was normal, there was no evidence for a primary liver disorder, and mental development was normal so that the coined word "mulibray" seemed inappropriate. pericardiectomy produced only partial improvement; both patients have hepatic enlargement and continue to need diuretics. A third patient with dwarfism, frequent respiratory infections, and pericardial calcification has certain features of the syndrome.- - - - - - - - - - ranking = 0.076701324087654keywords = physical (Clic here for more details about this article) |
5/11. Symptomatic pericardial constriction without active pericarditis.The decision to undergo pericardectomy for symptomatic pericardial constriction is usually dictated by an image of an abnormal pericardium. We report a case of symptomatic pericardial constriction despite radiographic and pathological evidence of a normal pericardium. The patient was successfully treated with a pericardectomy, with resolution of constrictive hemodynamics and symptoms. Our report suggests that a normal pericardium by computed tomography and biopsy should not preclude pericardectomy for patients who have refractory symptoms, physical findings, and intracardiac pressures diagnostic of constrictive pericarditis.- - - - - - - - - - ranking = 0.076701324087654keywords = physical (Clic here for more details about this article) |
6/11. Constrictive pericarditis without typical haemodynamic changes as a cause of oedema formation due to protein-losing enteropathy.A 41-year-old man presented with physical signs of leg oedema and a laboratory value of decreased serum albumin of 2.4 g.dl-1. Loss of protein via the gastrointestinal tract was demonstrated by an increased faecal excretion of 51-chromium-labelled-albumin and by elevated stool clearance of alpha 1-antitrypsin. No anatomical lesions or intestinal disease were found to explain this protein loss. Constrictive pericarditis was suspected as the cause of protein-losing enteropathy but could not be confirmed by right heart catheterization, in which normal filling pressures and no sign of 'dip and plateau' pressure pattern were found. However, magnetic resonance imaging clearly demonstrated a thickening of the pericardium over the right heart and a tubular-shaped right ventricle as signs of constrictive pericarditis. Peripheral oedema disappeared and serum protein concentration returned to normal after pericardectomy. This demonstrates that moderate pericardial constriction not resulting in discernible pressure abnormalities in the right heart can be associated with protein-losing enteropathy and thus result in hypoproteinaemic peripheral oedema. In this condition a morphological investigation by magnetic resonance imaging is of importance in order not to miss the diagnosis of a potentially treatable disease.- - - - - - - - - - ranking = 0.076701324087654keywords = physical (Clic here for more details about this article) |
7/11. Constrictive pericarditis after cardiac surgery: report of three cases and review of the literature.Constrictive pericarditis after cardiac surgery is a rare phenomenon occurring with an incidence of 0.2% to 0.3%. To date only 158 cases have been reported in the world literature. Symptoms include dyspnea (81%), chest pain (34%), and fatigue (29%). Peripheral edema (90%) and an elevated jugular venous pressure (86%) were the most common abnormal signs found during physical examination. Chest x-ray and ECG abnormalities were not helpful in making the diagnosis, and abnormal echocardiographic findings were reported in less than half of the cases. Computerized tomography and magnetic resonance imaging scans of the heart were usually of great diagnostic benefit. Diastolic equalization of cardiac pressures remains the sine que non for diagnosis. Oral steroids have been reported to favorably alter the course early in the disease, but pericardial stripping remains the definitive form of therapy. Operative mortality rates vary from 5.5% to 14.5%.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
8/11. Diagnostic features of localised pericardial constriction.We report a case of localised pericardial constriction leading to right ventricular outflow tract obstruction. Localised pericardial constriction is rare, but the diagnosis should be considered in patients who present with recurrent pericardial constriction following previous partial pericardiectomy. Close attention to physical findings may enable the diagnosis to be made prior to cardiac catheterisation.- - - - - - - - - - ranking = 0.076701324087654keywords = physical (Clic here for more details about this article) |
9/11. Left ventricular pseudoaneurysm causing superior vena caval obstruction and effusive-constrictive pericarditis.A diabetic woman with a silent myocardial infarction on clinical and electrocardiographic criteria presented with findings on physical examination of superior vena caval obstruction and effusive-constrictive pericarditis. A left ventricular posterior wall pseudoaneurysm and intrapericardial hematoma were found, with extrinsic compression of the right atrium. The diagnosis was first suspected by radionuclide imaging and confirmed by contrast angiography and surgery.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
10/11. Pericardial disease in rheumatoid arthritis.Six patients with rheumatoid constrictive pericarditis, five seen in a two and one half year period, are described. All patients were male, all had rheumatoid factor, and all had active arthritis. diagnosis was suspected from careful physical examination and confirmed in five patients by cardiac catheterization. pericardiectomy was successful in all five patients on whom it was performed. Rheumatoid constrictive pericarditis should be suspected in any patient with rheumatoid arthritis and unexplained signs of right heart failure.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
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