Cor calcium: heart trapped in a pericardial cage
نویسندگان
چکیده
for the evaluation of shortness of breath. Her previous medical record was unremarkable. ECG revealed negative T waves in the inferior and precordial derivations (Fig. 1). Chest X-ray showed dense calcification around the heart, compatible with a calcified pericardium (Fig. 2a, b). Two-dimensional transthoracic echocardiogram revealed severe thickening and calcification of the pericardium, leading to the strangulation of the heart, but the extent of pericardial calcifications could not be estimated (Fig. 3a, b; Video 1). Constrictive physiology was also noted. In contrast, live/real-time three-dimensional transthoracic echocardiography (3-D-TTE) enabled the visualization of massive pericardial calcifications around both the ventricles and right atrium (Fig. 4a, b; Video 2), thus establishing a diagnosis of pericarditis constrictiva calcarea. A relative sparing of the anterior and apical aspects of both ventricles was noted. Routine laboratory test results revealed normal electrolyte levels and normal renal, liver, parathyroid, and thyroid functions. The levels of myocardial injury biomarkers and inflammatory and rheumatic disease markers were also normal. Tuberculosis was excluded based on negative results of the PPD test. Cardiac multidetector computed tomography confirmed the 3-D-TTE findings, with volume-rendered images showing severe pericardial calcification surrounding nearly both the ventricles and atria (Fig. 5). Coronary angiography revealed normal left and right coronary arterE-page Original Images E-5 Anatol J Cardiol 2017; 18: E-3-6
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عنوان ژورنال:
دوره 18 شماره
صفحات -
تاریخ انتشار 2017