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Results for “PERICARDITIS, CONSTRICTIVE”

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At least 109 records · Page 6Linked to original sources
PubMed1997

[Anesthetic managements for pericardiectomy of three patients with constrictive pericarditis].

We experienced three patients with constrictive pericarditis who underwent pericardiectomy. Percutaneous cardiopulmonary support (PCPS) was carried out in two patients because of unstable hemodynamics caused by massive bleeding or cardiac compression due to surgical manipulation. In the other patient with severe tachycardia, we prepared PCPS before the induction of anesthesia, and could manage the whole course of anesthesia satisfactorily. It is suggested that PCPS is the most reliable way to support hemodynamics during anesthesia in patients with constrictive pericarditis.

Anesthesia↗
PubMed1990

[Surgical treatment of constrictive pericarditis].

Since 1957, 30 patients with constrictive pericarditis have been treated surgically in Kyushu University Hospital. The surgical approaches were the left anterolateral thoracotomy in 17 patients (group I); the median sternotomy without cardiopulmonary bypass (CPB) in 6 patients (group II); and the median sternotomy with CPB in 7 patients (group III). The hospital mortality was 3.3 percent. The mean postoperative follow-up period was 11.7 years (longest 30 years). The actuarial survival rate at 5 years postoperatively was 88% in total cases (100% in group I, 82% in group II and 52% in group III), 88% at 10 years, 75% at 15 years and 67% at 20 years. Several patients in group III, who underwent complete pericardiectomy using CPB showed severe congestive heart failure and arrhythmia postoperatively. The comparative study between an poor result group (patients who died within 10 years post-operatively) and a good result group (patients who survived more than 10 years postoperatively revealed that preoperative hepatomegaly, atrial fibrillation and the interval between the onset of symptoms and the pericardiectomy influenced the survival rate significantly. These results suggested that pericardiectomy using CPB was a safe method for removing the calcified pericardium in the patient with severe constrictive pericarditis. However, a careful long term follow-up was necessary for the patient with severe myocardial damage even though the complete pericardiectomy was performed.

Adolescent↗
PubMed1993

A fatal case of constrictive pericarditis due to a marked, selective pericardial accumulation of amyloid.

Distinguishing constrictive pericarditis from restrictive cardiomyopathy, usually due to amyloidosis, is a relatively frequent and difficult diagnostic problem. This report describes, for the first time, a patient with constrictive pericarditis caused by direct, extensive infiltration of the pericardium by amyloid, with only minimal amyloid in the myocardium, and a normal heart weight of 320 g. This patient demonstrates that amyloid may be predominantly deposited in the pericardium and actually cause constrictive pericarditis, as well as simulate its hemodynamic presentation by myocardial deposition. Given a clinical and hemodynamic presentation compatible with either constrictive or restrictive disease, an endomyocardial biopsy or other biopsy revealing amyloidosis does not necessarily rule out pericardial constriction that may be due to amyloid infiltration. The relationship between constrictive pericarditis, seen in this patient, and the other more common manifestations of amyloid heart disease, and the hemodynamic profiles of amyloid cardiomyopathy and constrictive pericarditis are reviewed.

Aged↗
PubMed1976

Usefulness of systolic time intervals in differential diagnosis of constrictive pericarditis and restrictive cardiomyopathy.

Systolic time intervals in 15 patients with constrictive pericarditis and seven patients with restrictive cardiomyopathy were compared in order to assess their value in the differential diagnosis of the two disorders. Clinical examination had failed to make the distinction. Right heart catheterization was helpful in diagnosing restriction but failed to differentiate patients with constrictive pericarditis from those with restrictive cardiomyopathy. The systolic time intervals clearly separated the two groups. The PEP/LVET was normal in all patients with constrictive pericarditis (0.34 +/- 0.01) and abnormal in all patients with restrictive cardiomyopathy (0.70 +/- 0.09, P less than 0.001). In 13 patients (five with restrictive cardiomyopathy and eight with constrictive pericarditis) the results of quantitative left ventricular angiocardiography were available. A high correlation (r=-0.90, P less than 0.01) between the PEP/LVET and the ejection fraction confirmed the validity of the PEP/LVET as a measure of left ventricular performance in these patients. Thus the systolic time intervals clearly distinguished between constrictive pericarditis and restrictive cardiomyopathy and are a reliable non-invasive technique for making the difficult differential diagnosis.

Adult↗
PubMed1975

Systolic time intervals in constrictive pericarditis. A study before and after digitalis.

Systolic time intervals were studied in 9 patients with documented constrictive pericarditis before and 15 to 20 minutes after intravenous administration of peruvoside (a quick acting digitalis-like glycoside) to determine underlying myocardial dysfunction. Data were compared with those of similarly studied normal subjects and patients with known myocardial dysfunction. Left ventricular ejection time index (LVETI) decreased in normal subjects (P less than 0.01) and in most patients with constrictive pericarditis, and increased marginally in those with myocardial dysfunction (NS) after peruvoside administration. Pre-ejection period index (PEPI) shortened significantly (P less than 0.01) after peruvoside in normal subjects and in patients with myocardial failure, but not in constrictive pericarditis. Likewise the predicted ejection fraction was insignificantly altered in constrictive pericarditis but significantly so (P less than 0.01) in myocardial failure and normal subjects. The response of one patient with constrictive pericarditis to parenteral peruvoside administration was similar to that seen in patients with myocardial failure. This patient had a delayed recovery after pericardiectomy. PEPI/LVETI ratio and ejection fraction were also abnormal in other patients with constrictive pericarditis when compared to normal subjects. Such abnormalities and the unusual response of some patients to administration of peruvoside may reflect underlying myocardial dysfunction in patients with constrictive pericarditis. However, it is possible that the rigid pericardium also contributes to these abnormalities to a varying extent. Systolic time indices and their response to digitalis appear to be a useful, atraumatic method for detecting underlying myocardial dysfunction in patients with constrictive pericarditis.

Adolescent↗
PubMed1984

Diagnosis of constrictive pericarditis by two-dimensional echocardiography: studies in a new experimental model and in patients.

The purpose of this study was to determine the value of two-dimensional echocardiography in detecting constrictive pericarditis. Serial two-dimensional echocardiography was performed in eight closed chest conscious dogs with experimental constrictive pericarditis, using a new model that creates constrictive pericarditis by the introduction of a pericardial irritant mixture. Constrictive pericarditis was confirmed in these dogs by cardiac catheterization and pathologic examination. Four patients with constrictive pericarditis and three patients with restrictive cardiomyopathy (amyloidosis) were also studied. Analysis of short-axis two-dimensional echocardiograms was performed to determine the frame by frame change in left ventricular cavity areas throughout diastole. Curves of diastolic left ventricular cavity area change versus percent duration of diastole were constructed for each animal and human subject. Pericardial thickness was measured at various gain settings on two-dimensional and M-mode echocardiograms and at post-mortem examination. In dogs with constrictive pericarditis, the echocardiograms seriously overestimated and correlated poorly with pathologic measurements of pericardial thickness. In dogs after constrictive pericarditis developed, 69 +/- 11% (mean +/- SD) (range 50 to 84) of cavity area change occurred in the initial 30% of diastole compared with 35 +/- 7% (range 20 to 45) in control two-dimensional echocardiograms (p less than 0.001). Four patients with constrictive pericarditis showed similar accelerated cavity expansion in early diastole, but three patients with cardiac amyloidosis showed more variable left ventricular diastolic expansion rates. It is concluded that two-dimensional echocardiograms can demonstrate characteristic diastolic filling abnormalities in constrictive pericarditis, but cannot accurately measure pericardial thickness.

Amyloidosis↗
PubMed1988

Reduced diastolic left ventricular posterior wall motion in patients with constrictive pericarditis--incidence, hemodynamic and clinical correlations.

In 24 patients with constrictive pericarditis proven by cardiac catheterization, the amplitude of diastolic left ventricular posterior wall motion was evaluated by M-mode echocardiography and compared to the results of 24 healthy volunteers. The amplitude was significantly less in constrictive pericarditis patients than in normal controls (0.3 +/- 0.2 mm versus 3.9 +/- 0.4 mm) (P less than 0.001). No constrictive pericarditis patient demonstrated a higher value than 2 mm whereas none of the healthy volunteers had an amplitude less than 3 mm. In 11 of 13 constrictive pericarditis patients who underwent pericardiectomy, an increase in amplitude was observed. In 6 patients the amplitude returned to normal limits after surgery. No significant correlation between the degree of heart failure or the level of left ventricular end-diastolic pressure and the reduction of the amplitude was found. In addition, the amplitude of left ventricular diastolic posterior wall motion did not allow a clear separation between patients who could be treated medically and those requiring pericardiectomy.

Adult↗