Document Detail


Constrictive pericarditis: a cause of exertion-induced dyspnea in a soldier with a prior sternotomy.
MedLine Citation:
PMID:  18062402     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diagnosing the underlying etiology of dyspnea on exertion in adults can be challenging, often requiring the clinician to distinguish cardiac or pulmonary pathological conditions from metabolic, neurological, or hematological conditions or from chest wall abnormalities. We report such a case involving a 29-year-old, male, active duty Army soldier. With a history of a median sternotomy, symptoms of right- and left-side heart failure, and examination findings suggesting elevated right atrial pressure, pericardial disease was pursued. Echocardiography and cardiac catheterization revealed constrictive physiological features, namely, elevation and near-equalization of right- and left-side pressures and ventricular interdependence, whereas computed tomography illustrated pericardial thickening, ultimately leading to the diagnosis of constrictive pericarditis. The patient was treated with a complete pericardiectomy, leading to symptom resolution and improved exercise capacity. This case report of a rare condition offers a concise etiological and physiological overview of constrictive pericarditis and demonstrates an effective multimodal diagnostic approach. The scientific evidence provided may assist general practitioners in making decisions to differentiate this clinical condition from similar cardiac or cardiopulmonary conditions.
Authors:
Daniel A Bellin; Patrick J Devine
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Military medicine     Volume:  172     ISSN:  0026-4075     ISO Abbreviation:  Mil Med     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-07     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2984771R     Medline TA:  Mil Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1220-3     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Walter Reed Army Medical Center, Washington, DC 20307, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Dyspnea / etiology*
Exercise Tolerance
Humans
Male
Military Medicine
Military Personnel
Pericarditis, Constrictive / complications*,  ultrasonography
Sternum / surgery*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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