Document Detail

Constrictive pericarditis versus restrictive cardiomyopathy: challenges in diagnosis and management.
MedLine Citation:
PMID:  15476569     Owner:  NLM     Status:  MEDLINE    
This is the case of a patient who presented with severe right-sided heart failure due to diastolic dysfunction that caused a dilemma of differential diagnosis between restrictive cardiomyopathy and constrictive pericarditis. Restrictive cardiomyopathy was diagnosed based on noninvasive and invasive hemodynamic testing. However, the patient did not respond to therapy and succumbed to worsening heart failure and multiple comorbidities. Clinical features of right heart failure with edema, ascites, jugular venous distention, and tender hepatomegaly are commonly seen in clinical practice. When systolic function is determined to be normal, diastolic causes of heart failure must be ruled out. These include myocardial disorders with a broad range of pathologies leading to restrictive physiology, of which amyloidosis is a prototype. Pericardial disorders leading to diastolic heart failure are usually in the form of constrictive physiology, when pericardial tamponade is ruled out. Differentiation between restrictive and constrictive pathologies is often difficult and requires careful attention to hemodynamic and Doppler echocardiographic features. We report a case of severe right heart failure illustrating some of the complexities in decision-making and the importance of meticulous hemodynamic and ancillary testing in the diagnosis and treatment of this often fatal condition.
Kavitha M Chinnaiyan; Carrie B Leff; Dominic L Marsalese
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article    
Journal Detail:
Title:  Cardiology in review     Volume:  12     ISSN:  1061-5377     ISO Abbreviation:  Cardiol Rev     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2004-10-12     Completed Date:  2005-02-17     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  314-20     Citation Subset:  IM    
Department of Cardiology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
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MeSH Terms
Cardiomyopathy, Restrictive / diagnosis,  physiopathology,  ultrasonography
Diagnosis, Differential
Fatal Outcome
Heart Catheterization
Magnetic Resonance Imaging
Pericarditis, Constrictive / diagnosis*,  physiopathology,  therapy*,  ultrasonography
Ventricular Pressure

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