Subacute effusive-constrictive pericarditis

Clinical and hemodynamic observations are reported in 13 patients who demonstrated a distinct pathophysiologic form of compressive pericardial disease characterized by effusion into a free pericardial space associated with constriction of the heart by the visceral pericardium. The pericardial disease was idiopathic (nine patients) or subsequent to radiotherapy (four patients), with a maximal duration of symptoms of 16 months. Enlarged heart shadow, prominent paradoxical pulse, predominant systolic dip in the venous pressure pulse, and absence of atrial fibrillation were features that tended to distinguish the effusive-constrictive cases from those with noneffusive chronic constrictive pericarditis. The value of pressure measurements during combined cardiac catheterization and pericardiocentesis is emphasized in the differentiation of effusive-constrictive pericarditis from cardiac tamponade without constriction. Four patients were observed to progress through an effusive-constrictive phase to noneffusive constrictive pericarditis. Corticosteroids, pericardiocentesis, and other medical therapy produced some benefit but did not relieve constriction. The results of surgery were generally satisfactory.

Irradiation-induced constrictive pericarditis in intestinal lymphangiectasis

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Intraperisidial cyst formation in constrictive pericarditis simulating tricuspid stenosis

Two cases of constrictive pericarditis with intrapericardial cyst formation are presented. In each, a tricuspid diastolic murmur was present, and confirmation of a tricuspid valve gradient was obtained at cardiac catheterization. Angiographic studies revealed that the tricuspid valves were distorted by the cysts. In both patients, surgical excision was successfully achieved.

In case 1 a blood-containing cyst was found, the etiology of which is obscure. Case 2 was associated with rheumatoid arthritis, and the compression resulted from a chronic abscess that probably arose at a previous pericardiectomy.

A complicated case of cor triatriatum dexter

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Pulmonary stenosis due to external compression by a pericardial band

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Cardiac tamponade in constrictive pericarditis following cardiac catheterization

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