Document Detail

Constrictive pericarditis impressing and narrowing the ascending aorta.
MedLine Citation:
PMID:  18754936     Owner:  NLM     Status:  MEDLINE    
A 77-year-old male patient was admitted to our institution with 1-year history of progressive dyspnea on exertion, and lower extremity edema. His chest x-ray showed a circumferential pericardial calcification and right-sided pleural effusion. The electrocardiography revealed atrial fibrillation with low voltage in all derivations and diffuse nonspecific T-wave inversions. The transesophageal echocardiography showed a thickened pericardium with biatrial enlargement and normal right and left ventricular systolic functions. A thick echogenic structure that caused impression and narrowing of the ascending aorta was observed. Simultaneous right and left heart catheterization showed elevation and equalization of right-sided and left-sided diastolic filling pressures, with characteristic dip and plateau. Aortic angiogram showed the ascending aorta was impressed and narrowed by calcified pericardium. Cine magnetic resonance imaging showed pericardial calcifications impressing and narrowing of the ascending aorta. All these findings were consistent with constrictive pericarditis. The patient had no history of tuberculosis, cardiac surgery, or mediastinal irradiation. His HIV antibody test was negative. Marked pericardial thickening and calcifications were evident during pericardiectomy. Histological analysis of the pericardium showed dense collageneous matrix, mild chronic inflammation and calcification. The culture of pericardial tissue revealed no identifiable cause including tuberculosis. The patient was diagnosed as idiopathic constrictive pericarditis. The patient's symptoms and edema decreased remarkably after pericardial stripping. He remained well at 1-year follow-up.
Aylin Tugcu; Ozlem Yildirimturk; Cihan Duran; Saide Aytekin
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  25     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-29     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  768-71     Citation Subset:  IM    
Department of Cardiology, Florence Nightingale Hospital, Istanbul, Turkey.
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MeSH Terms
Aorta / pathology*
Calcinosis / pathology*,  radiography
Diagnostic Imaging / methods*
Echocardiography, Transesophageal
Follow-Up Studies
Magnetic Resonance Imaging, Cine
Pericardiectomy / methods
Pericarditis, Constrictive / diagnosis*,  surgery
Radiography, Thoracic
Risk Assessment
Severity of Illness Index
Treatment Outcome

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

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