2015, Number 3
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Rev Mex Cardiol 2015; 26 (3)
Effusive-constrictive pericarditis: a review
Arceo-Navarro A, Harrison-Gómez C, Sánchez-Lezama F, Domínguez-Carrillo LG, Arredondo-Arzola V
Language: English
References: 52
Page: 140-148
PDF size: 269.60 Kb.
ABSTRACT
Background: Effusive-constrictive pericarditis is an uncommon clinical hemodynamic syndrome in which constriction of the heart by the visceral pericardium occurs in the presence of tense effusion in a free pericardial space. This variety of constrictive pericarditis was observed and characterized by Hancock in 1971. The hallmark of effusive-constrictive pericarditis is the persistence of elevated right atrial pressure after intrapericardial pressure has been reduced to normal levels by removal of pericardial fluid. The causes are diverse and its course may be reversible or more frequently requiring extensive pericardiectomy.
Clinical case: 35 year old male without an important medical history, with dyspnea and chest pain secondary to airway infection, in whom a diagnosis of pericardial effusion was made, handled with colchicine and NSAIDs, he presented decreased of pericardial effusion but worsening hemodynamic alterations corroborated by echocardiography. Diagnosed as an effusive-constrictive pericarditis a pericardiectomy was performed with excellent evolution. After multiple diagnostic tests the disease was catalogued like an idiopathic form.
Conclusions: Effusive-constrictive pericarditis is a rare syndrome and it should be considered in the evolution of patients with pericardial effusion.
REFERENCES
Hancock EW. Subacute effusive-constrictive pericarditis. Circulation. 1971; 43: 183-192.
Santa Cruz RJ, Sahagún SG, González CD, Sánchez GN. Análisis de las características clínicas, ecocardiográficas, microbiológicas y citopatológicas de derrames pericárdicos en un hospital de tercer nivel de atención. Arch Cardiol Mex. 2014; 84: 86-91.
3- Sagrista SA, Merce J, Permanyer MG et al. Clinical clues to the causes of large pericardial effusions. Am J Med. 2000; 109: 95-101.
4- Aguilar J, Summerson C, González E et al. Pericarditis tuberculosa Experiencia de 10 años. Arch Cardiol Mex. 2007; 77: 209-216.
5- Lind A, Reinsch N, Neuhaus K et al. Pericardial effusion of HIV-infected patients? Results of a prospective multicenter cohort study in the era of antiretroviral therapy. Eur J Med Res. 2011; 16: 480-483.
Pankuweit S, Ristic AD, Seferovic PM, Maisch B. Bacterial pericarditis: diagnosis and management. Am J Cardiovasc Drugs. 2005; 5: 103-112.
Ling LH, Oh JK, Schaff HV et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. 1999; 100: 1380-1386.
Natanzon A, Kronzon I. Pericardial and pleural effusions in congestive heart failure-anatomical, pathophysiologic, and clinical considerations. Am J Med Sci. 2009; 338: 211-216.
Corey G, Campbell P, van Trigt P et al. Etiology of large pericardial effusions. Am J Med. 1993; 95: 209-213.
Ben-Horin S, Bank I, Shinfeld A, Kachel E, Guetta V, Livneh A. Diagnostic value of the biochemical composition of pericardial effusions in patients undergoing pericardiocentesis. Am J Cardiol. 2007; 99: 1294-1297.
Maisch B, Seferovic P, Ristic A. Guidelines on the diagnosis and management of pericardial diseases executive summary: The Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology. Eur Heart J. 2004; 25:587.
Hoit BD. Pericardial disease and pericardial tamponade. Crit Care Med. 2007; 35 Suppl: S355-364.
Permanyer-Miralda G, Sagristá-Sauleda J, Soler-Soler J. Primary acute pericardial disease: a prospective series of 231 consecutive patients. Am J Cardiol. 1985; 56: 623-630.
Nugue O, Millaire A, Porte H et al. Pericardioscopy in the etiologic diagnosis of pericardial effusion in 141 consecutive patients. Circulation. 1996; 94: 1635-1641.
Sagrista-Sauleda J, Angel J, Permanyer-Miralda G. Long-term follow-up of idiopathic chronic pericardial effusion. N Engl J Med. 1999; 341: 2054-2059.
Tsang T, Enriquez-Sarano M, Freeman W et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: Clinical profile, practice patterns, and outcomes spanning 21 years. May Clin Proc. 2002; 77: 429-436.
Ramírez F, Sarmiento M, Orjuela T et al. Características clínicas y ecocardiográficas de los derrames pericárdicos en pacientes del Hospital Universitario de San Vicente de Paúl. IATREIA. 2002; 15: 135-142.
Beck C. Two cardiac compression triads. JAMA. 1935; 104: 714-716.
Cheema M, Ghalib M, Shatoor A et al. Pattern of pericardial disease in the Asir Region of Saudi Arabia. Ann Saudi Med. 2007; 19: 171-173.
Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Outcomes of clinically significant idiopathic pericardial effusion requiring intervention. Am J Cardiol. 2003; 91: 704-707.
Troughton RW, Asher CR, Klein AL. Pericarditis. Lancet. 2004; 363: 717-727.
Little WC, Freeman GL. Pericardial disease. Circulation. 2006; 113: 1622-1632.
Meyers DG, Bagin RG, Levene JF. Electrocardiographic changes in pericardial effusion. Chest. 1993; 104: 1422-1426.
Eisenberg MJ, de Romeral LM, Heidenreich PA. The diagnosis of pericardial effusion and cardiac tamponade by 12-lead ECG. A technology assessment. Chest. 1996; 110: 318-324.
Bruch C, Schmermund A, Dagres N et al. Changes in QRS voltage in cardiac tamponade and pericardial effusion: reversibility after pericardiocentesis and after anti-inflammatory drug treatment. J Am Coll Cardiol. 2001; 38: 219-226.
Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003; 349: 684-690.
Pepi M, Muratori M. Echocardiography in the diagnosis and management of pericardial disease. J Cardiovasc Med. 2006; 7: 533-544.
Gandhi S, Schneider A, Mohiuddin S et al. Has the clinical presentation and clinician’s index of suspicion of cardiac tamponade changed over the past decade? Echocardiography. 2008; 25: 237-241.
Naqvi TZ, Huynh HK. A new window of opportunity in echocardiography. J Am Soc Echocardiogr. 2006; 19: 569-577.
Horowitz MS, Schultz CS, Stinson EB et al. Sensitivity and specificity of echocardiographic diagnosis of pericardial effusion. Circulation. 1974; 50: 239-247.
Karia DH, Xing YQ, Kuvin JT, Nesser HJ, Pandian NG. Recent role of imaging in the diagnosis of pericardial disease. Curr Cardiol Rep. 2002; 4: 33-40.
Restrepo CS, Lemos DF, Lemos JA, et al. Imaging findings in cardiac tamponade with emphasis on CT. Radiographics. 2007; 27: 1595-1610.
Eichler K, Zangos S, Thalhammer A et al. CT-guided pericardiocenteses: clinical profile, practice patterns and clinical outcome. Eur J Radiol. 2010; 75: 28-31.
Ben-Horin S, Bank I, Shinfeld A et al. Diagnostic value of the biochemical composition of pericardial effusions in patients undergoing pericardiocentesis. Am J Cardiol. 2007; 99: 1294-1297.
Kim SH, Kwak MH, Park S et al. Clinical characteristics of malignant pericardial effusion associated with recurrence and survival. Cancer Res Treat. 2010; 42: 210-216.
Aguilar JA, Summerson C, González ME et al. Pericarditis tuberculosa. Experiencia de 10 años Arch Cardiol Mex. 2007; 77: 209-216.
Refaat MM, Katz WE. Neoplastic pericardial effusion. Clin Cardiol. 2011; 34: 593-598.
Meurin P, Tabet JY, Thabut G et al. Nonsteroidal anti-inflammatory drug treatment for postoperative pericardial effusion: a multicenter randomized, double-blind trial. Ann Intern Med. 2010; 152: 137-143.
Imazio M, Belli R, Brucato A et al. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP 2): a multicentre, double-blind, placebo-controlled, randomized trial. Lancet. 2014; DOI:10.1016/S0140-6736(13)62709-9.
Imazio M, Brucato A, Cumetti D et al. Corticosteroids for recurrent pericarditis: high versus low doses: a nonrandomized observation. Circulation. 2008; 118 (6): 667-671.
Rosenbaum E, Krebs E, Cohen M et al. The spectrum of clinical manifestations, outcome and treatment of pericardial tamponade in patients with systemic lupus erythematosus: a retrospective study and literature review. Lupus. 2009; 18: 608-612.
Maisch B, Ristic AD, Pankuweit S. Intrapericardial treatment of autoreactive pericardial effusion with triamcinolone; the way to avoid side effects of systemic corticosteroid therapy. Eur Heart J. 2002; 23: 1503-1508.
Artom G, Koren-Morag N, Spodick DH et al. Pretreatment with corticosteroids attenuates the efficacy of colchicine in preventing recurrent pericarditis: a multi-centre all-case analysis. Eur Heart J. 2005; 26: 23-727.
Allen KB, Faber LP, Warren WH. Pericardial effusion: subxiphoid pericardiostomy versus percutaneous catheter drainage. Ann Thorac Surg. 1999; 67: 437-440.
Nugue O, Millaire A, Porte H et al. Pericardioscopy in the etiologic diagnosis of pericardial effusion in 141 consecutive patients. Circulation. 1996; 94: 1635-1641.
Spodick DH, Kumar S. Subacute constrictive pericarditis with cardiac tamponade. Dis Chest. 1968; 54: 62-66.
D’Cruz IA, Pallas CW, Heck A. Echocardiographic diagnosis of effusive-constrictive pericarditis due to staphylococcal pericarditis after cardiac surgery. South Med J. 1991; 84: 1375-1377.
Castañón GA, AmézquitaLJ, Velasco OE, Deseano EJ, León GM. Pericarditis constrictiva: historia de un corazón oprimido Cir Cir. 2010; 78: 342-346.
Walsh TJ, Baughman KL, Gardner TJ, Bulkley BH. Constrictive epicarditis as a cause of delayed or absent response to pericardiectomy: a clinicopathological study. J Thorac Cardiovasc Surg. 1982; 83: 126-132.
Cameron J, Oesterle SN, Baldwin JC, Hancock EW. The etiologic spectrum of constrictive pericarditis. Am Heart J. 1987; 113: 354-360.
Watanabe A, Hara Y, Hamada M et al. A case of effusive-constructive pericarditis: an efficacy of GD-DTPA enhanced magnetic resonance imaging to detect a pericardial thickening. Magn Reson Imaging. 1998; 16: 347-350.
Sagrista SJ, Permanyer MG, Candell RJ, Angel J et al. Transient cardiac constriction: an unrecognized pattern of evolution in effusive acute idiopathic pericarditis. Am J Cardiol. 1987; 59: 961-966.