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Query: UMLS:C0018801 (heart failure)
 72,216 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 43-year-old man with idiopathic hypereosinophilic syndrome survived a relatively long term (6 1/2 years) before he succumbed to intractable heart failure. Six months before death, his chronic heart failure from restrictive cardiomyopathy was well compensated. Autopsy demonstrated severe constrictive pericarditis which was not suspected antemortem. Constrictive pericarditis as a late complication of idiopathic hypereosinophilic syndrome is discussed.
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PMID:Severe constrictive pericarditis as an unsuspected cause of death in a patient with idiopathic hypereosinophilic syndrome and restrictive cardiomyopathy. 341 16

Constrictive pericarditis is a rare complication of cardiac surgery. Among 7851 patients who underwent cardiac surgery at Nantes University Hospital, postoperative constrictive pericarditis was diagnosed in 5 patients: 0.63%. All patients were men aged 49 to 77 years (mean 62.5) Four patients underwent coronary artery bypass graft surgery and one patient required mitral and aortic valve replacement. The mean time to onset of symptoms after the first operation was 21 months. The main clinical symptom was right ventricular failure. In all patients, the diagnosis was established by right catheterization which showed diastolic dip-plateau. A radical pericardectomy was performed in all but one of the patients, who was treated medically. Clinical signs resolved in all five patients. The diagnosis of constriction after cardiac-surgery is not easy, as the symptoms are non-specific. A symptomatic patient believed to have myocardial failure after cardiac-surgery could therefore actually instead have occult constriction.
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PMID:[Constrictive pericarditis after cardiac surgery]. 876 Nov 10

Constrictive pericarditis can be associated with ICD patch electrodes. During a mean follow-up of 24 months, in a population of 35 patients who received ICDs with a patch electrodes configuration, we identified three patients with clinical and hemodynamic signs compatible with this event. Patient 1, a 35-year-old male, underwent implantation of an ICD because of a primary electrical disease complicated by cardiac arrest. Fourteen months later he complained of exertional dyspnea without any signs of heart failure. Right heart catheterization showed high filling pressures and diastolic dip and plateau in pressure curves. Thoracotomy and pericardial exploration were performed. Three months after removal of the patches and insertion of an endocardial lead system, the patient had normal respiration. Patients 2 and 3, who suffered from coronary heart disease without heart failure, exhibited a hemodynamic profile suggestive of constrictive pericarditis: in one patient, 10 months after ICD implantation, associated with right heart failure; and in the other, 18 months after ICD implantation with left heart failure. Patch electrodes were removed in these two patients and replaced by endocardial lead electrodes with subsequent clinical improvement. It is concluded that constrictive pericarditis related to epicardial patch is not an uncommon occurrence during ICD therapy and should be considered in patients who show clinical signs of cardiac decompensation.
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PMID:Symptomatic pericardial disease associated with patch electrodes of the automatic implantable cardioverter defibrillator: an underestimated complication? 899 57

A 73-yr-old woman with a 4 yr history of rheumatoid arthritis presented with the clinical features of congestive cardiac failure. She had a good early response to standard therapy although she subsequently developed recurrent biventricular failure. The preservation of good ventricular function on echocardiography in the face of clinical evidence of myocardial insufficiency raised the possibility of constrictive pericarditis, which was confirmed on cardiac catheterization. Constrictive pericarditis should be considered in patients with rheumatoid arthritis who develop unexplained cardiac failure. Early diagnosis requires a high index of suspicion and cardiac catheterization may be necessary to confirm the diagnosis. Medical treatment is largely ineffective and pericardiectomy should be considered.
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PMID:Rheumatoid constrictive pericarditis. 911 46

Two cases of familial porphyria cutanea tarda (PCT) with constrictive pericarditis are described. A 50-year-old woman and her 48-year-old younger brother were admitted because of right ventricular heart failure. Constrictive pericarditis was diagnosed by RV pressure waveform and echocardiogram. The patients were diagnosed as PCT based on clinical symptoms, histologic findings and elevated urinary excretion levels of uroporphyrin. Even to this day, over 40% of the etiology of constrictive pericarditis remains unknown. There is a possibility of overlooking porphyria cutanea tarda in constrictive pericarditis patients. This report describes the first documented cases of familial PCT with constrictive pericarditis.
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PMID:Porphyria cutanea tarda with constrictive pericarditis in a family. 946 24

Constrictive pericarditis after coronary artery bypass grafting (CABG) is rare and can present as unexplained dyspnea. We report five consecutive cases of post-CABG constrictive pericarditis seen within a period of 17 months at our institution. All patients presented with heart failure of unknown etiology within a period of 8-84 months after surgery. During the initial post-CABG period, two patients had developed postcardiotomy syndrome that was successfully treated with steroids. They were all assessed noninvasively and invasively. In all patients, the diagnosis of constriction was initially suspected clinically (symptoms, high jugular venous pressure with deep "X" and "Y" descents, pericardial knock). Echocardiography showed transmitral flow typical of constriction in all patients and hepatic venous flow in two. Two patients showed rapid left ventricular relaxation. In all patients, hemodynamic assessment showed diastolic equalization of pressures in all chambers, "W" shape waveform in right atrial pressure, and "dip and plateau" configuration in right and left ventricular pressure waveforms. Diagnosis was confirmed surgically in four patients who were subjected to pericardiectomy-pericardial stripping (three survived, one died). One patient refused surgery. We conclude that constrictive pericarditis, although rare, should be suspected in every case of unexplained dyspnea post CABG. It can appear early or late after surgery, and clinical examination plays an important role in its early recognition. It requires a full noninvasive and invasive assessment in case of clinical suspicion.
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PMID:Constrictive pericarditis after coronary artery bypass surgery as a cause of unexplained dyspnea: a report of five cases. 975 89

Constrictive pericarditis is an uncommon condition. Previously, tuberculosis or other bacterial infections were prevalent causes, often with prominent pericardial calcification. Presently, many patients with constrictive pericarditis of other aetiologies have lesser degrees of structural changes in the pericardium. We report on a case with severe symptoms where the correct diagnosis was elusive because of absent or minimal preoperative pericardial pathology. The clinical, echocardiographic and haemodynamic features of constrictive pericarditis are reviewed. We recommend thorough echocardiographic evaluation of central haemodynamics in patients with symptoms of heart failure when the aetiology is not readily apparent (e.g. previous myocardial infarction dilated cardiomyopathy or valvular disease.
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PMID:[Constrictive pericarditis illustrated by an unusual case report]. 985 5

Constrictive pericarditis is an uncommon disorder with various causes. Although most often idiopathic, it may also occur after cardiovascular surgery, radiation therapy, and tuberculosis, especially in developing countries. The encasement of the heart by a rigid, nonpliable pericardium results in characteristic pathophysiologic effects, including impaired diastolic filling of the ventricles, exaggerated ventricular interdependence, and dissociation of intracardiac and intrathoracic pressures during respiration. Constrictive pericarditis typically presents with chronic insidious signs and symptoms of predominantly systemic venous congestion. Notoriously difficult to diagnose and distinguish from restrictive cardiomyopathy (RCM), the use of cardiac catheterization, echocardiography (transthoracic and transesophageal), central venous (hepatic and pulmonary) and transvalvular Doppler measurements, and magnetic resonance imaging should secure the diagnosis in most cases, eliminating the need for diagnostic thoracotomy. Although medical treatment may temporarily alleviate symptoms of heart failure, patients do poorly without pericardiectomy.
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PMID:Constrictive pericarditis: clinical and pathophysiologic characteristics. 1042 32

We describe two cases of severe constrictive pericarditis arising after allogeneic BMT conditioning involving total body irradiation and melphalan to treat Philadelphia-chromosome positive ALL. Both patients required pericardectomy, resulting in marked improvement in ventricular filling. However, a degree of right-sided cardiac failure persisted in both patients secondary to restrictive cardiomyopathy. Constrictive pericarditis has not been previously described after BMT, but has been observed following thoracic radiotherapy for malignancy, usually involving a substantially higher radiation dose. Pericardial constriction and restrictive cardiomyopathy should be considered as causes of breathlessness and/or oedema occurring late after BMT. Bone Marrow Transplantation (2000) 25, 571-573.
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PMID:Constrictive pericarditis post allogeneic bone marrow transplant for Philadelphia-positive acute lymphoblastic leukaemia. 1071 38

Constrictive pericarditis is an uncommon but treatable cause of heart failure that results from a variety of acute inflammatory processes. Corticosteroids appear to prevent the development of constriction in selected patients with active pericardial inflammation. Symptoms of right-sided heart failure usually predominate and can be adequately managed with diuretics. Complete surgical pericardiectomy remains the only definitive treatment. The mortality risk is markedly increased in patients with advanced symptoms, and surgery should be performed in earlier stages. The majority of patients (95% on average) will survive the surgery; complete relief of symptoms occurs in about 50% of survivors. Ten percent of patients will have persistent symptomatic heart failure (New York Heart Association functional class III or IV) and experience poor late outcomes, however, particularly when residual myocardial dysfunction coexists.
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PMID:Constrictive Pericarditis. 1109 70


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