García JP, Ruiz PV, Vázquez MJC, Gallegos SM, Padua GMAX, Peña MES

Language: Spanish
References: 7
Page: 84-87
PDF size: 200.14 Kb.

ABSTRACT

Farmer of 38 years sent to Emergency Department by dyspnea of small efforts of 6 months of evolution, accompanied by increase of the abdominal diameter, edema of pelvic members, unquantified ponderal loss and pericardial effusion of 450 mL. Diagnostic paracentesis a lymphocytic exudate with adenosin deaminasa (ADA) of 35 U, transthoracic echocardiography that demonstrates constrictive pericarditis with serious diastolic dysfunction, calcium hyper-refringence and patch deposits in pericardium, thoracoabdominal CT scan shows bilateral pleural effusion, pericardic thickening › 10 mm and ascitis. The patient go to Pericardiectomy and surgeon’s observed extensive fibrosis of pericardium (Concretio cordis) and the pleuropericardic biopsy shows cheesy granulomas confirming the diagnosis of poliserositis and constrictive pericarditis of tuberculous origin. Iniciated treatment with antituberculous drugs and systemic steroid and repeats echocardiogram to the 30 days showing improvement in the diastolic function as well as decrease of the pericardic inflammation and the systolic pressure of the pulmonary artery.

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