Effusive‐constrictive pericarditis in a patient with end‐stage renal disease (RCD code: VI‐4D.1)
Renal disease, especially end‐stage renal disease, is associated with possible pericardial involvement. We report the case of a 51‐year‐old patient with a history of end‐stage‐renal disease, currently receiving chronic haemodialysis. The patient was admitted to the ward due decreased exercise tolerance and elevation of inflammatory markers. Features of active exudative‐constrictive pericarditis were detected
upon imaging studies (echocardiography, computed tomography). The haemodialysis regimen was intensified and anti‐inflammatory treatment was administered. In the follow‐up examination, the patient presented with improved clinical status and echocardiography revealed a decreased amount of pericardial fluid with no pattern of constriction. The elevation of CRP and evidence of active pericardial
inflammation upon contrast enhancement seen in CT may help to identify patients with potentially reversible forms of pericardial con‐ striction. In this group of patients, in addition to intensification of dialysis, anti‐inflammatory therapy should be considered to prevent the need for pericardiectomy. JRCD 2019; 4 (2): 47-50.
Alpert MA, Ravenscraft MD. Pericardial involvement in end‐stage renal dis‐ ease. Am J Med Sci 2003; 325: 228–236.
Gunukula SR, Spodick DH. Pericardial disease in renal patients. Semin Nephrol 2001; 21: 52–56.
Haley JH, Tajik AJ, Danielson GK, et al. Transient constrictive pericarditis: causes and natural history. J Am Coll Cardiol 2004; 43: 271 – 275.
Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of pa‐ tients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 2013; 26: 965–1012.
Cosyns B, Plein S, Nihoyanopoulos P, et al. European Association of Cardiovascular Imaging (EACVI) position paper: multimodality imaging. Eur Heart J – Cardiovasc Imaging 2015; 16(1): 12–31.
Schwefer M, Aschenbach R, Heidemann J, et al. Constrictive pericarditis, still a diagnostic challenge: comprehensive review of clinical management. Eur J Cardiothorac Surg 2009; 36: 502 –510.
Imazio M, Brucato A, Maestroni S, et al. Risk of constrictive pericarditis after acute pericarditis. Circulation, 2011; 124: 1270–1275.
Adler Y, Charron P, Imazio M, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) endorsed by: The European Association for Cardio‐Thoracic Surgery (EACTS). Eur Heart J 2015; 36: 2921–2964.
Oh JK, Hatle LK, Seward JB, et al. Diagnostic role of Doppler echocardiography in constrictive pericarditis. J Am Coll Cardiol 1994; 23: 154 –162.
Palka P, Lange A, Donnelly JE, et al. Differentiation between restrictive cardiomyopathy and constrictive pericarditis by early diastolic Doppler myocardial velocity gradient at the posterior wall. Circulation 2000; 102: 655 –662.
Talreja DR, Edwards WD, Danielson GK, et al. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation 2003; 108: 1852–1857.
Imazio M, Brucato A, Mayosi BM, et al. Medical therapy of pericardial diseases: part II: noninfectious pericarditis, pericardial effusion and constrictive peri‐ carditis. J Cardiovasc Med (Hagerstown), 2010; 11: 785–794.
Maisch B, Seferović PM, Ristić AD, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary. Eur Heart J 2004; 25: 587–610.
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