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Effusive-Constrictive Pericarditis in a Young Active Duty Male

Authors
  • Kalra, Arjun G1
  • Sharp, Alec J2
  • Dinkha, Laith2
  • Gore, Rosco2
  • 1 Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, USA
  • 2 Cardiology, Brooke Army Medical Center, Fort Sam Houston, USA
Type
Published Article
Journal
Cureus
Publisher
Cureus
Publication Date
Aug 24, 2020
Volume
12
Issue
8
Identifiers
DOI: 10.7759/cureus.9997
PMID: 32983696
PMCID: PMC7511065
Source
PubMed Central
Keywords
License
Green
External links

Abstract

Effusive-constrictive pericarditis (ECP) is a rare clinical entity resulting from accumulating pericardial fluid within a stiff, non-compliant pericardium. There are a number of etiologies for ECP, which include malignancy, radiation, post-surgical causes, infectious, and collagen disorders. Clinically, ECP often presents as right-sided heart failure, or in advanced cases, cardiac tamponade. Symptoms may persist despite treatment with pericardiocentesis, and may warrant consideration for pericardiectomy for more definitive management. Invasive hemodynamic evaluation with cardiac catheterization remains the gold standard for diagnosis of ECP; however, echocardiography can provide a definitive diagnosis with high sensitivity and specificity. Echocardiographic features suggestive of ECP include ventricular septal motion abnormalities, such as interdependence, accentuated longitudinal motion of the heart, and altered respirophasic ventricular filling. While these features have been well established and can lead to the diagnosis of ECP, they are rarely observed in clinical practice. We present a case of ECP in a 25-year-old active duty male with a history of chest wall myoepithelial carcinoma who clearly demonstrated such echocardiographic findings of ECP.

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