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Al-Mallah MH, Almasoudi F, Ebid M, Ahmed AM, Jamiel A. Multimodality Imaging of Pericardial Diseases. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017; 19:89. [PMID: 29027095 DOI: 10.1007/s11936-017-0590-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OPINION STATEMENT Pericardial diseases have changed their epidemiology in the past few years. With the aging population and decreasing incidence of communicable diseases, the causes of pericardial diseases have significantly changed from infectious and malignant to postradiation and cardiac surgery causes. Despite that, pericardial diseases remain difficult to diagnose. The accurate and timely diagnosis of these diseases is essential to avoid the late sequela of pericardial constriction and pericardial cirrhosis. Echocardiography remains the first test of choice for the assessment of patients with suspected pericardial diseases. Most patients with acute pericarditis have a self-limiting course and do not need further imaging. However, in the era of multimodality imaging, other modalities, namely, computed tomography (CT) and magnetic resonance imaging (CMR), are often utilized in complex cases. These two modalities provide a wide-open view of the pericardium and adjacent structures. They have high resolution to assess pericardial calcification, a hallmark of many diseases especially tuberculous constrictive pericarditis. CMR is also unique in its ability to assess pericardial late gadolinium enhancement (LGE) and edema. These have been recently suggested to be very important in the progression from acute pericarditis to constrictive pericarditis. In addition, they provide prognostic value to assess which patients are at high risk of developing heart failure and resource utilization. Thus, in the current era, patients with suspected complex pericardial diseases will need a multimodality approach rather than a single modality approach.
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Affiliation(s)
- Mouaz H Al-Mallah
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. .,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. .,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. .,Division Head, Cardiac Imaging, King Abdulaziz Cardiac Center, King Abdulaziz Medical City for National Guard, King Saud bin Abdulaziz University for Health Sciences, Departmental Code: 1413, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
| | - Fatimah Almasoudi
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Mohamed Ebid
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Amjad M Ahmed
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdelrahman Jamiel
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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