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Title: Early-onset post-cardiotomy severe constrictive pericarditis: a case report
Authors: Mikhail, Philopatir ;Meere, William ;Howden, Nicklas ;Spina, Roberto 
Affliation: Central Coast Local Health District
Gosford Hospital
Issue Date: 16-Aug-2022
Source: 6(9): ytac342.
Journal title: European heart journal. Case reports
Department: Cardiology
Abstract: Constrictive pericarditis (CP) can be one of the most challenging conditions to diagnose within cardiovascular medicine. Iatrogenic causes of CP are increasingly recognized in higher income countries. This case provides insight into the need for clinical suspicion when diagnosing this relatively under recognized clinical entity as well as the need for multimodality imaging combined with invasive haemodynamic assessment. A 68-year-old man presented with decompensated heart failure 4 weeks after open-heart surgery. A diagnosis of early-onset post-cardiotomy CP was made using multimodality imaging and invasive haemodynamic assessment, which demonstrated the cardinal features of constrictive physiology. Surgical intervention with two pericardiectomy procedures was pursued given the aggressive and recalcitrant nature of his presentation. Our patient died shortly after his second surgery due to progressive multi-organ dysfunction. Constrictive pericarditis is a challenging but important clinical entity to diagnose. Differentiating CP from restrictive cardiomyopathy is important as there are key differences in management and prognosis. Our case supports the clinical utility of multimodality imaging combined with invasive haemodynamic assessment in patients with suspected CP.
DOI: 10.1093/ehjcr/ytac342
Publicaton type: Journal Article
Keywords: Cardiology
Heart Disease
Study or Trial: Case Series and Case Reports
Appears in Collections:Cardiology

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