eMedicine Specialties > Radiology > Cardiac

Constrictive Pericarditis: Multimedia

Author: John S To, MD, Consulting Staff, Department of Radiology, Dickinson County Healthcare System
Contributor Information and Disclosures

Updated: Jul 24, 2007

Multimedia

A man presented with an 8-year history of slow wo...
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Media file 1: A man presented with an 8-year history of slow worsening of exercise intolerance, weight gain, and dyspnea. His chest radiograph shows a normal-sized heart. Calcifications are not visible in the pericardium on the frontal view. The azygos vein is moderately distended.
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A man presented with an 8-year history of slow wo...

A man presented with an 8-year history of slow worsening of exercise intolerance, weight gain, and dyspnea. His chest radiograph shows a normal-sized heart. Calcifications are not visible in the pericardium on the frontal view. The azygos vein is moderately distended.

Chest radiograph lateral view of the same patient...
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Media file 2: Chest radiograph lateral view of the same patient as in Image 1 also fails to show pericardial calcifications.
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Chest radiograph lateral view of the same patient...

Chest radiograph lateral view of the same patient as in Image 1 also fails to show pericardial calcifications.

Hepatobiliary scans were obtained for the patient...
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Media file 3: Hepatobiliary scans were obtained for the patient also seen in Images 1 and 2 because of liver function abnormalities. The radiopharmaceutical slowly clears from the hepatic parenchyma despite prompt visualization of the common bile duct and gallbladder.
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Hepatobiliary scans were obtained for the patient...

Hepatobiliary scans were obtained for the patient also seen in Images 1 and 2 because of liver function abnormalities. The radiopharmaceutical slowly clears from the hepatic parenchyma despite prompt visualization of the common bile duct and gallbladder.

The liver in this CT scan is poorly enhanced, con...
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Media file 4: The liver in this CT scan is poorly enhanced, congested, and enlarged. The aorta is poorly opacified, and passage of the contrast-agent bolus is mildly delayed.
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The liver in this CT scan is poorly enhanced, con...

The liver in this CT scan is poorly enhanced, congested, and enlarged. The aorta is poorly opacified, and passage of the contrast-agent bolus is mildly delayed.

The cardiac chambers in this CT scan of the heart...
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Media file 5: The cardiac chambers in this CT scan of the heart are not enlarged and are approximately the same size. Focal pericardial calcifications are noted. The noncalcified portion of the pericardium is not particularly thickened, but it seems tightly adherent to the epicardium.
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The cardiac chambers in this CT scan of the heart...

The cardiac chambers in this CT scan of the heart are not enlarged and are approximately the same size. Focal pericardial calcifications are noted. The noncalcified portion of the pericardium is not particularly thickened, but it seems tightly adherent to the epicardium.

The interventricular septum in this CT scan of th...
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Media file 6: The interventricular septum in this CT scan of the heart is slightly straightened or bowed to the left. Note the delayed opacification of the aorta.
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The interventricular septum in this CT scan of th...

The interventricular septum in this CT scan of the heart is slightly straightened or bowed to the left. Note the delayed opacification of the aorta.

Note the pericardial calcification inferior to th...
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Media file 7: Note the pericardial calcification inferior to the heart in this CT scan. Marked dilatation of the inferior vena cava is present despite the absence of cardiac chamber dilatation. The patient's disease responded completely to a total pericardiectomy.
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Note the pericardial calcification inferior to th...

Note the pericardial calcification inferior to the heart in this CT scan. Marked dilatation of the inferior vena cava is present despite the absence of cardiac chamber dilatation. The patient's disease responded completely to a total pericardiectomy.

CT image obtained of the heart 8 years earlier sh...
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Media file 8: CT image obtained of the heart 8 years earlier shows no pericardial calcifications.
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CT image obtained of the heart 8 years earlier sh...

CT image obtained of the heart 8 years earlier shows no pericardial calcifications.

Image obtained in a patient who presented with an...
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Media file 9: Image obtained in a patient who presented with an increasing serum creatinine level, peripheral edema, and signs of low cardiac output. This nonenhanced abdominal CT scan of the heart (obtained because of renal failure) shows mild but diffuse and circumferential pericardial thickening.
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Image obtained in a patient who presented with an...

Image obtained in a patient who presented with an increasing serum creatinine level, peripheral edema, and signs of low cardiac output. This nonenhanced abdominal CT scan of the heart (obtained because of renal failure) shows mild but diffuse and circumferential pericardial thickening.

Slightly caudal image in this CT scan of the hear...
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Media file 10: Slightly caudal image in this CT scan of the heart shows deviation of the intraventricular septum to the left.
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Slightly caudal image in this CT scan of the hear...

Slightly caudal image in this CT scan of the heart shows deviation of the intraventricular septum to the left.

The interatrial septum in this CT scan of the hea...
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Media file 11: The interatrial septum in this CT scan of the heart is bowed to the left because of an elevated right atrial filling pressure.
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The interatrial septum in this CT scan of the hea...

The interatrial septum in this CT scan of the heart is bowed to the left because of an elevated right atrial filling pressure.

Constrictive pericarditis.
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Media file 12: Constrictive pericarditis.
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Constrictive pericarditis.

Constrictive pericarditis.

Constrictive pericarditis.
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Media file 13: Constrictive pericarditis.
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Constrictive pericarditis.

Constrictive pericarditis.

Constrictive pericarditis.
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Media file 14: Constrictive pericarditis.
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Constrictive pericarditis.

Constrictive pericarditis.

More on Constrictive Pericarditis

Overview: Constrictive Pericarditis
Imaging: Constrictive Pericarditis
Follow-up: Constrictive Pericarditis
Multimedia: Constrictive Pericarditis
References
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References

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  2. Correa SD, Amsterdam EA. Images in cardiovascular medicine. Constrictive pericarditis. Circulation. Mar 3 1998;97(8):806. [Medline].

  3. Di Cesare E. MRI of the cardiomyopathies. Eur J Radiol. Jun 2001;38(3):179-84. [Medline].

  4. Fernando Guadalajara J, Vera-Delgado A, Gaspar-Hernandez J. Echocardiographic Aspects of Restrictive Cardiomyopathy: Their Relationship with Pathophysiology. Echocardiography. Apr 1998;15(3):297-314. [Medline].

  5. Gomes Ferreira SM, Gomes Ferreira A Jr, do Nascimento Morais A. Constrictive chronic pericarditis in children. Cardiol Young. Mar 2001;11(2):210-3. [Medline].

  6. Gujral V, Lopez-Candales A, Abdelhadi R, Crock F, Gulyasy B, et al. Constrictive pericarditis: an unusual clinical entity suggested during dobutamine stress echocardiography. Int J Cardiol. Nov 10 2006;113(2):e58-61. [Medline].

  7. Guneri S, Nazli C, Kinay O. Chylous ascites due to constrictive pericarditis. Int J Card Imaging. Feb 2000;16(1):49-54. [Medline].

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  11. Karadede A, Ulgen MS, Temamogullari AV. A complicated case of pericardial hydatid cyst manifesting as constrictive pericarditis. Can J Cardiol. May 2000;16(5):673-6. [Medline].

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  13. Marshall A, Ring N, Lewis T. Constrictive pericarditis: lessons from the past five years' experience in the South West Cardiothoracic Centre. Clin Med. Nov-Dec 2006;6(6):592-7. [Medline].

  14. McCully RB, Higano ST, Oh JK. Diagnosis of constrictive pericarditis. Circulation. May 11 1999;99(18):2476. [Medline].

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  16. Moosdorf R. Indications, results, and pitfalls in the surgery of constrictive pericarditis. Herz. Dec 2000;25(8):794-8. [Medline].

  17. Palka P, Lange A, Donnelly JE. Differentiation between restrictive cardiomyopathy and constrictive pericarditis by early diastolic doppler myocardial velocity gradient at the posterior wall. Circulation. Aug 8 2000;102(6):655-62. [Medline].

  18. Pepine CJ, Nissen SE, eds. CathSAP: Cardiac Catheterization and Interventional Cardiology Self-assessment Program. American College of Cardiology. 1999.

  19. Ridruejo E, Laurini J, Cingolani O. [Fulminant hepatic failure. Atypical form of cardiac failure presentation]. Medicina (B Aires). 2000;60(4):491-4. [Medline].

  20. Robles P, Rubio A, Olmedilla P. Value of multidetector cardiac CT in calcified constrictive pericarditis for pericardial resection. Heart. Aug 2006;92(8):1112. [Medline].

  21. Trent JC, Lau TK, Kawashima A. Constrictive pericarditis from an embolized hypodermic needle: radiographic, CT and MR imaging findings. Int J Card Imaging. Apr 2000;16(2):117-23. [Medline].

  22. Van der Merwe S, Dens J, Daenen W. Pericardial disease is often not recognised as a cause of chronic severe ascites. J Hepatol. Jan 2000;32(1):164-9. [Medline].

  23. Watanabe A, Sakata J, Kawamura H. Primary pericardial mesothelioma presenting as constrictive pericarditis: a case report. Jpn Circ J. May 2000;64(5):385-8. [Medline].

  24. Wettstein M, Haussinger D. [Constrictive pericarditis--a differential diagnosis in therapy refractory ascites]. Dtsch Med Wochenschr. Dec 1 2000;125(48):1462-5. [Medline].

  25. Zimand S, Benjamin P, Frand M. Constrictive pericarditis presented by generalized edema (anasarca). Isr Med Assoc J. Apr 2000;2(4):316-7. [Medline].

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Further Reading

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Keywords

CP, constriction of the cardiac chambers, pericardium, thickened pericardium, pericardial thickening, stiffened pericardium, pericardial stiffening

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Contributor Information and Disclosures

Author

John S To, MD, Consulting Staff, Department of Radiology, Dickinson County Healthcare System
John S To, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Radiology, American Medical Association, American Roentgen Ray Society, Massachusetts Medical Society, Michigan State Medical Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Medical Editor

Justin D Pearlman, MD, ME, PhD, MA, Director of Dartmouth Advanced Imaging Center, Professor of Medicine, Professor of Radiology, Adjunct Professor, Thayer Bioengineering and Computer Science, Dartmouth-Hitchcock Medical Center
Justin D Pearlman, MD, ME, PhD, MA is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Federation for Medical Research, International Society for Magnetic Resonance in Medicine, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Robert M Steiner, MD, Professor of Radiology, Temple University School of Medicine, Clinical Professor of Radiology, Medical School of the University of Pennsylvania; Consulting Radiologist, Temple University Hospital, Temple University Children's Medical Center
Robert M Steiner, MD is a member of the following medical societies: American College of Cardiology, American College of Chest Physicians, American College of Radiology, American Heart Association, Radiological Society of North America, and Society of Thoracic Radiology
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Staff, Department of Radiology, Virginia Mason Medical Center
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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