Pericardiectomy and Results in A Patient With Pre-Diagnosis of Constrictive Pericarditis. A Case Report

Abstract

In constrictive pericarditis, due to pericardial inflammation, the parietal and visceral pericardial leaves adhere to each other, scarring and losing elasticity. This prevents filling of the ventricles in diastole. As a result of fibrotic pericardium preventing the filling of the heart in diastole, venous return to the heart decreases. Cardiac output decreases secondary to decreased venous return. This clinical picture is associated with constrictive pericarditis. The most common cause of constrictive pericarditis in developing countries is tuberculosis infection. In this article, we describe a 53-year-old patient diagnosed with constrictive pericarditis who presented to the emergency department of our center with dyspnea for about 1 month. Echocardiographic examination performed under emergency conditions showed floating heart appearance, septal bounce movement and compression of right heart structures. Two attempts of pericardiocentesis under echocardiographic guidance were unsuccessful. The pericardial cavity could not be accessed because of the rigid structure of the pericardium. The mediastinum was then evaluated by tomographic examination. CT scan revealed severe accumulation and calcified areas around the heart. It was observed that the anterior surface of the heart was adherent to the sternum and an operation was planned with a prediagnosis of constrictive pericarditis.