Pediatric Constrictive Pericarditis Follow-up

  • Author: Brian D Soriano; Chief Editor: Stuart Berger, MD   more...
 
Updated: May 11, 2012
 

Further Inpatient Care

Low cardiac output may occur postoperatively in patients who are debilitated and who have ascites or other findings of fluid retention.

Patients with low cardiac output may require maintenance of high left atrial pressure, sympathomimetic infusions, or both.

Mechanical support of the circulation, such as extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon counterpulsation, can be used in patients who are critically ill.

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Transfer

Transfer to a tertiary care center with cardiothoracic surgeons and critical care services for pediatric patients is the only referral needed.

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Prognosis

The prognosis after pericardial resection/stripping is excellent as long as the underlying myocardium is unaffected.

Occasionally, the etiology of the constriction may cause coincident myocardial dysfunction.

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Patient Education

Pericardial constriction does not recur in the absence of an intact pericardium.

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Contributor Information and Disclosures
Author

Brian D Soriano  MD, Assistant Professor of Pediatrics, Cardiology Division, University of Washington School of Medicine; Attending Physician, Pediatric Cardiology and Cardiac Imaging, Seattle Children's Hospital

Brian D Soriano is a member of the following medical societies: American Heart Association, American Medical Association, and American Society of Echocardiography

Disclosure: Nothing to disclose.

Coauthor(s)

Charles I Berul, MD  Professor of Pediatrics and Integrative Systems Biology, George Washington University School of Medicine; Chief, Division of Cardiology, Children's National Medical Center

Charles I Berul, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, Cardiac Electrophysiology Society, Heart Rhythm Society, Pediatric and Congenital Electrophysiology Society, and Society for Pediatric Research

Disclosure: Johnson & Johnson Consulting fee Consulting

Renee E Margossian, MD  Instructor, Department of Cardiology, Children's Hospital, Harvard University; Consulting Staff, Department of Cardiology, Boston Medical Center and Brigham and Women's Hospital

Renee E Margossian, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Society of Echocardiography, and Heart Failure Society of America

Disclosure: Nothing to disclose.

Kurt Pflieger, MD, FAAP  Active Staff, Department of Pediatrics, Lake Pointe Medical Center

Kurt Pflieger, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Christopher Johnsrude, MD, MS  Chief, Division of Pediatric Cardiology, University of Louisville School of Medicine; Director, Congenital Heart Center, Kosair Children's Hospital

Christopher Johnsrude, MD, MS is a member of the following medical societies: American Academy of Pediatrics and American College of Cardiology

Disclosure: St Jude Medical Honoraria Speaking and teaching

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Hugh D Allen, MD  Professor, Department of Pediatrics, Division of Pediatric Cardiology and Department of Internal Medicine, Ohio State University College of Medicine

Hugh D Allen, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Pediatric Society, American Society of Echocardiography, Society for Pediatric Research, Society of Pediatric Echocardiography, and Western Society for Pediatric Research

Disclosure: Nothing to disclose.

Gilbert Z Herzberg, MD  Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College; Consulting Staff, Department of Pediatrics, Sound Shore Medical Center

Gilbert Z Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Stuart Berger, MD  Professor of Pediatrics, Division of Cardiology, Medical College of Wisconsin; Chief of Pediatric Cardiology, Medical Director of Pediatric Heart Transplant Program, Medical Director of The Heart Center, Children's Hospital of Wisconsin

Stuart Berger, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American College of Chest Physicians, American Heart Association, and Society for Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Additional Contributors

The authors would like to thank Kurt Pflieger, MD, FAAP for his significant contributions and original work for this article.

References

  1. Chen CA, Lin MT, Wu ET, et al. Clinical manifestations and outcomes of constrictive pericarditis in children. J Formos Med Assoc. Jun 2005;104(6):402-7. [Medline].

  2. Thompson JL, Burkhart HM, Dearani JA, Cetta F, Oh JK, Schaff HV. Pericardiectomy for pericarditis in the pediatric population. Ann Thorac Surg. Nov 2009;88(5):1546-50. [Medline].

  3. Leya FS, Arab D, Joyal D, et al. The efficacy of brain natriuretic peptide levels in differentiating constrictive pericarditis from restrictive cardiomyopathy. J Am Coll Cardiol. Jun 7 2005;45(11):1900-2. [Medline].

  4. Abdalla IA, Murray RD, Awad HE, Stewart WJ, Thomas JD, Klein AL. Reversal of the pattern of respiratory variation of Doppler inflow velocities in constrictive pericarditis during mechanical ventilation. J Am Soc Echocardiogr. Sep 2000;13(9):827-31. [Medline].

  5. Atwood JE, Osterberg L. Images in clinical medicine. Constrictive pericarditis. N Engl J Med. Jul 13 2000;343(2):106. [Medline].

  6. Balg S, Stengel-Rutkowski S, Döhlemann C, Boergen K. Mulibrey nanism. Clin Dysmorphol. Jan 1995;4(1):63-9. [Medline].

  7. Boonyaratavej S, Oh JK, Tajik AJ, et al. Comparison of mitral inflow and superior vena cava Doppler velocities in chronic obstructive pulmonary disease and constrictive pericarditis. J Am Coll Cardiol. Dec 1998;32(7):2043-8. [Medline].

  8. Buendia A, Attie F, Martinez-Lavin M. The syndrome of pericarditis, arthritis, and camptodactyly: an under- recognized cause of pericardial constriction in children?. Cardiol Young. Sep 1999;9(5):526-8. [Medline].

  9. Bush CA, Stang JM, Wooley CF, Kilman JW. Occult constrictive pericardial disease. Diagnosis by rapid volume expansion and correction by pericardiectomy. Circulation. Dec 1977;56(6):924-30. [Medline].

  10. Canver CC, Patel AK, Kosolcharoen P, Voytovich MC. Fungal purulent constrictive pericarditis in a heart transplant patient. Ann Thorac Surg. Jun 1998;65(6):1792-4. [Medline].

  11. Chen SJ, Li YW, Wu MH, et al. CT and MRI findings in a child with constrictive pericarditis. Pediatr Cardiol. May-Jun 1998;19(3):259-62. [Medline].

  12. Chien SJ, Liang CD, Ko SF, Chang JP. Idiopathic calcific constrictive pericarditis causing pulmonary stenosis associated with a ventricular septal defect mimicking tetralogy of Fallot. J Clin Ultrasound. May 2003;31(4):222-5. [Medline].

  13. Choi EY, Ha JW, Kim JM, et al. Incremental value of combining systolic mitral annular velocity and time difference between mitral inflow and diastolic mitral annular velocity to early diastolic annular velocity for differentiating constrictive pericarditis from restrictive cardiomyopathy. J Am Soc Echocardiogr. Jun 2007;20(6):738-43. [Medline].

  14. Francone M, Dymarkowski S, Kalantzi M, et al. Assessment of ventricular coupling with real-time cine MRI and its value to differentiate constrictive pericarditis from restrictive cardiomyopathy. Eur Radiol. Apr 2006;16(4):944-51. [Medline].

  15. Haley JH, Tajik AJ, Danielson GK, et al. Transient constrictive pericarditis: causes and natural history. J Am Coll Cardiol. Jan 21 2004;43(2):271-5. [Medline].

  16. Hatle L. Diastolic dysfunction in restrictive and constrictive heart disease. In: Left Ventricular Diastolic Dysfunction and Heart Failure. 1994:390-407.

  17. Hatle LK, Appleton CP, Popp RL. Differentiation of constrictive pericarditis and restrictive cardiomyopathy by Doppler echocardiography. Circulation. Feb 1989;79(2):357-70. [Medline].

  18. Himelman RB, Lee E, Schiller NB. Septal bounce, vena cava plethora, and pericardial adhesion: informative two-dimensional echocardiographic signs in the diagnosis of pericardial constriction. J Am Soc Echocardiogr. Sep-Oct 1988;1(5):333-40. [Medline].

  19. Kim BJ, Ma JS. Constrictive pericarditis after surgical closure of atrial septal defect in a child. J Korean Med Sci. Dec 1998;13(6):658-61. [Medline].

  20. Kloeters C, Dushe S, Dohmen PM, et al. Evaluation of left and right ventricular diastolic function by electron-beam computed tomography in patients with passive epicardial constraint. J Comput Assist Tomogr. Jan-Feb 2008;32(1):78-85. [Medline].

  21. Kojima S, Yamada N, Goto Y. Diagnosis of constrictive pericarditis by tagged cine magnetic resonance imaging. N Engl J Med. Jul 29 1999;341(5):373-4. [Medline].

  22. Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation. Sep 28 1999;100(13):1380-6. [Medline].

  23. Little WC, Freeman GL. Pericardial disease. Circulation. Mar 28 2006;113(12):1622-32. [Medline].

  24. Lock JE, Keane JF, Fellows KE. Hemodynamic evaluation of congenital heart disease. In: Diagnostic and Interventional Catheterization in Congenital Heart Disease. 1987:33-62.

  25. Mehta A, Mehta M, Jain AC. Constrictive pericarditis. Clin Cardiol. May 1999;22(5):334-44. [Medline].

  26. Meyer RJ, Goldberg SJ, Donnerstein RL. Superior vena cava and hepatic vein velocity patterns in normal children. Am J Cardiol. Jul 15 1993;72(2):238-40. [Medline].

  27. Myers RB, Spodick DH. Constrictive pericarditis: clinical and pathophysiologic characteristics. Am Heart J. Aug 1999;138(2 Pt 1):219-32. [Medline].

  28. Oh KY, Shimizu M, Edwards WD, et al. Surgical pathology of the parietal pericardium: a study of 344 cases (1993-1999). Cardiovasc Pathol. Jul-Aug 2001;10(4):157-68. [Medline].

  29. Senni M, Redfield MM, Ling LH, et al. Left ventricular systolic and diastolic function after pericardiectomy in patients with constrictive pericarditis: Doppler echocardiographic findings and correlation with clinical status. J Am Coll Cardiol. Apr 1999;33(5):1182-8. [Medline].

  30. Spodick DH. The Pericardium: A Comprehensive Textbook. New York, NY: Marcel Dekker, Inc; 1997.

  31. Talreja DR, Edwards WD, Danielson GK, et al. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation. Oct 14 2003;108(15):1852-7. [Medline].

  32. Talreja DR, Nishimura RA, Oh JK, Holmes DR. Constrictive pericarditis in the modern era: novel criteria for diagnosis in the cardiac catheterization laboratory. J Am Coll Cardiol. Jan 22 2008;51(3):315-9. [Medline].

  33. Tom CW, Oh JK, Spittell PC. The abdominal aorta and constrictive pericarditis: abdominal aortic respiratory variation as an echocardiographic finding in constrictive pericarditis. J Am Soc Echocardiogr. Mar 2005;18(3):282-4. [Medline].

  34. Vaitkus PT, Kussmaul WG. Constrictive pericarditis versus restrictive cardiomyopathy: a reappraisal and update of diagnostic criteria. Am Heart J. Nov 1991;122(5):1431-41. [Medline].

  35. Veeragandham RS, Goldin MD. Surgical management of radiation-induced heart disease. Ann Thorac Surg. Apr 1998;65(4):1014-9. [Medline].

  36. Yamada H, Tabata T, Jaffer SJ, et al. Clinical features of mixed physiology of constriction and restriction: echocardiographic characteristics and clinical outcome. Eur J Echocardiogr. Jun 2007;8(3):185-94. [Medline].

  37. Yetkin U, Kestelli M, Yilik L, et al. Recent surgical experience in chronic constrictive pericarditis. Tex Heart Inst J. 2003;30(1):27-30. [Medline]. [Full Text].

  38. Zagol B, Minderman D, Munir A, D'Cruz I. Effusive constrictive pericarditis: 2D, 3D echocardiography and MRI imaging. Echocardiography. Nov 2007;24(10):1110-4. [Medline].

 
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MRI image of constrictive pericarditis in a 13-year-old and an otherwise structurally normal heart. Infectious workup was negative. (Image courtesy of Tal Geva, M.D.)
Left ventricular volume curve in constrictive pericarditis.
 
 
 
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