We describe a patient who suffered progressive right heart failure of unknown aetiology, despite a lengthy series of hospital investigations. Constrictive pericarditis had not been suspected during life, and was ultimately diagnosed as an autopsy finding. The salient clinical features and confirmatory investigations for this unusual disorder are reviewed. The case reminds us to consider the pos...

Effusive constrictive cholesterol pericarditis is exceedingly rare. Most cases have an unclear etiology but can be associated with rheumatoid arthritis, tuberculosis infection, and hypothyroidism. The hallmark of the effusion is the distinctively high levels of cholesterol. We present the case of a 68-year-old male with prolonged symptoms of dyspnea with associated moderate pericardial effusion...

The number of radiofrequency catheter ablation (RFA) procedures performed in the epicardial space is increasing. Major acute complications (primarily pericardial bleeding) and delayed complications have been reported in 5% and 2% of cases, respectively. To the best of our knowledge, a single case of constrictive pericarditis after multiple epicardial ablations for ventricular tachycardia has be...

PATIENT Female, 62 FINAL DIAGNOSIS: Tricuspid regurgitation Symptoms: Dyspnea exertional • fatigue • leg edema MEDICATION - Clinical Procedure: - Specialty: Cardiology. OBJECTIVE Challenging differential diagnosis. BACKGROUND Tricuspid regurgitation (TR) can mimic some hemodynamic findings of constrictive pericarditis (CP), due to the restraining effect of the enlarged right heart on inta...

Purulent pericarditis (PP) is a potentially life-threatening disease. Reported mortality rates are between 20 and 30%. Constrictive pericarditis occurs over the course of PP in at least 3.5% of cases. The frequency of persistent PP (chronic or recurrent purulent pericardial effusion occurring despite drainage and adequate antibiotherapy) is unknown because this entity was not previously classif...

OBJECTIVE Mural inflammation has been shown to contribute to the development of plaque, with the α(V)β(3) integrin highly expressed in atherosclerotic plaques. We herein examined α(V)β(3) integrin expression as a function of carotid atherosclerosis formation in the apolipoprotein E-deficient (apoE(-/-)) mouse. METHODS AND RESULTS Constrictive collars were placed around the left common carotid...

The hemodynamic findings in five patients are presented in order to demonstrate the variability in the clinical and physiologic patterns that may be encountered in restrictive disease of the pericardium. The mechanical effects of pericardial encasement previously described were confirmed. Furthermore, it was found that myocardial insufficiency and hypervolemia were not only important causative ...

T HE essential pathology of constrictive pericarditis is the partial replacement of the epicardium and superficial myocardial layers by inelastic fibrous tissue. This interferes with diastolic filling of the ventricles and is recorded during right ventricular catheterization as a high end-diastolic plateau. In addition, the encasing and infiltrating lesion interferes with contractility and ther...

Small GTPase Rho and its target Rho-kinase/ROK/ROCK play an important role in various cellular functions, including smooth muscle contraction, actin cytoskeleton organization, and cell adhesion and migration, all of which may be involved in the pathogenesis of arteriosclerosis. Here, we show that adenovirus-mediated transfer of dominant-negative Rho-kinase (DNRhoK) induces a marked regression o...

P RESSURE patterns from the right auricle and ventricle in constrictive pericarditis were first described in 1946 by Bloomfield and associates' and recently by Hansen and associates2 and McKusick.3 The right auricular pressure curve consists of (a) an M or W shaped pattern with two upward and two downward deflections, (b) moderately or markedly elevated mean pressure and (c) failure of the down...