Circulation. 1997;96:1034-1035
(Circulation. 1997;96:1034-1035.)
© 1997 American Heart Association, Inc.
Constrictive Pericarditis
Mark C. Thel, MD;
H. Newland Oldham, Jr, MD;
;
Robert H. Peter, MD
From the Division of Cardiology, Department of Internal Medicine
(M.C.T.), the Division of Thoracic Surgery (H.N.O.), and the Division of
Cardiology, Department of Internal Medicine (R.H.P.), Duke University Medical
Center, Durham, NC.
Correspondence to Mark C. Thel, MD, Box 3625, Duke University Medical Center, Durham, NC 27710.
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Introduction
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Top
Introduction
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A 47-year-old woman
was referred for evaluation of an 18-month
history of progressive
anorexia, fatigue, and dyspnea on exertion.
She was unable to walk up
seven steps in her split-level house
without resting.
Physical examination was most remarkable for jugular venous
distension. The chest radiograph (A) demonstrated a
right pleural effusion and dense pericardial calcification.
Simultaneous left (LV) and right (RV)
ventricular filling pressures (C) revealed
diastolic pressure elevation and early
diastolic "dip and plateau" waveform, commonly
referred to as the "square root sign." The tracings are
essentially superimposable throughout diastole. An
intraoperative photograph (B) illustrates the densely
calcified pericardium. The mean right atrial pressure decreased from 20
to 12 mm Hg at completion of partial pericardiectomy. Pathology
and microbiology specimens were nondiagnostic. Eight months
later she had complete resolution of symptoms and was able to complete
18 holes of golf, walking without difficulty.
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Footnotes
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Reprint requests to Robert H. Peter, MD, Box 3033, Duke University
Medical Center, Durham, NC 27710.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.