Patient with constrictive pericarditis (RCD code: III)
52-year-old Caucasian man was admitted with clinical symptoms of chronic heart failure. Constrictive pericarditis was suspected almost 9 years before admission, but Patient refused to diagnosis. Peripheral oedema, ascites, hepatomegaly, increased jugular venous pressure and pleural effusion were present on admission. Laboratory test showed increased level of Brain Natriuretic Peptide with normal levels of liver enzymes and total bilirubin. Chest X-ray revealed calcifications of pericardium, in echocardiography biatrial enlargement was present with septal bounce, dilated inferior vena cava, respiratory variation of mitral and tricuspid inflow. Computed tomography showed massive calcifications of pericardium and hydrothorax of both pleural cavities. Cardiac magnetic resonance confirmed enlargement of both artia with dyssynchrony of intraventricular septum’s motion and pericardium thickening. Cardiac catheterization confirmed diagnosis of constrictive pericarditis. Patient was qualified for pericardiectomy. He died during procedure due to bleeding complications. According to ESC Guidelines, pericardiectomy is the treatment of choice in patients with significant symptoms with mortality rate 6-12%.
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