Bettencourt, N

Carvalho, M

Leite, D

Ribeiro, S

Ribeiro, VG

Van Zeller, P

English

Institutional repository of Hospital de Braga

Document downRev Port Cardiol. 2012;31(12):835--836Revista Portuguesa deCardiologiaPortuguese Journal of Cardiologywww.revportcardiol.orgIMAGE IN CARDIOLOGYConstrictive  pericarditis:  Insights  from  cardiac  computedtomographyPericardite  Constritiva  sob  a  perspetiva  da  tomografia  computorizadacardíacaSílvia Ribeiroa,∗, Nuno Bettencourtb, Pedro Van Zellerc, Daniel Leiteb,Mónica  Carvalhob, Vasco Gama Ribeiroba Serviço  de  Cardiologia,  Hospital  de  Braga,  Braga,  Portugalb Serviço  de  Cardiologia,  Centro  Hospitalar  de  Vila  Nova  de  Gaia/Espinho,  Vila  Nova  de  Gaia,  Portugalc Serviço  de  Cardiologia,  Hospital  de  São  João,  Porto,  PortugalReceived  10  May  2012;  accepted  27  May  2012loaded from http://http://www.elsevier.pt, day 14/12/2012. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.Available  online  20  November  2012avddcrwcteConstrictive  pericarditis  is  a  rare  disease,  usually  theresult  of  long-standing  pericardial  inflammation  leading  topericardial  scarring  with  thickening,  fibrosis,  and  calcifica-tion.  The  most  frequent  causes  are  mediastinal  radiation,chronic  idiopathic  pericarditis,  cardiac  surgery,  and  tuber-culous  pericarditis.  Nearly  9%  of  patients  with  acutepericarditis  for  any  reason  go  on  to  develop  constrictivephysiology.We  report  the  case  of  a  52-year-old  man  with  a  history  ofacute  pericarditis  30  years  ago,  with  a  three-year  evolutionof  fatigue,  dyspnea  and  palpitations.  Physical  examina-tion  revealed  jugular  venous  distension  and  hepatomegalyand  a  pericardial  knock  was  audible  on  cardiac  ausculta-tion.  The  12-lead  electrocardiogram  revealed  atrial  flutter∗ Corresponding author.E-mail address: silviamartinsribeiro@gmail.com (S. Ribeiro).ppp0870-2551/$  –  see  front  matter  ©  2012  Sociedade  Portuguesa  de  Cardiologhttp://dx.doi.org/10.1016/j.repc.2012.05.013nd  the  transthoracic  echocardiogram  showed  distorted  leftentricular  geometry.  Cardiac  computed  tomography  (CT)emonstrated  pericardial  thickening  and  extensive  pericar-ial  calcification  (Figure  1A,B  and  C),  mostly  mid-cardiac,ausing  distortion  of  left  ventricular  morphology.  Markedestriction  to  diastolic  ventricular  filling  was  observed,ith  diastolic  apical  dilatation  (Figure  1D  and  E).  Cardiacatheterization  showed  ventricular  pressure  waveforms  withhe  classic  dip-and-plateau  physiology  and  equalization  ofnd-diastolic  pressures  of  both  ventricles,  compatible  withericardial  constriction.This  case  highlights  the  role  of  cardiac  CT  as  an  appro-riate  imaging  technique  for  the  diagnosis  of  constrictiveericarditis.ia  Published  by  Elsevier  España,  S.L.  All  rights  reserved.836  S.  Ribeiro  et  al.Figure  1  Multidetector  computed  tomography  post-processed  volume  rendered  images  (A,  B  and  C)  showing  the  thickened  andcalcified pericardium  and  its  relations  with  the  coronary  arteries  and  cardiac  chambers.  Maximum  intensity  projection  images  inlong- (D)  and  short-axis  (E)  views  in  different  phases  of  the  cardiac  cycle  illustrate  restricted  myocardial  movement  and  diastolica adia(EPdaCdRdConflicts  of  interestDocument downloaded from http://http://www.elsevier.pt, day 14/12/2012. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.pical dilatation.  Tube  current  modulation  was  used  to  reduce  rnote differences  in  image  quality  in  systole  and  diastole).thical disclosuresrotection  of  human  and  animal  subjects.  The  authorseclare  that  no  experiments  were  performed  on  humans  ornimals  for  this  investigation.onfidentiality  of  data.  The  authors  declare  that  no  patientata  appear  in  this  article.Ttion  exposure,  with  full  current  applied  only  in  diastolic  phasesight  to  privacy  and  informed  consent.  The  authorseclare  that  no  patient  data  appear  in  this  article.he  authors  have  no  conflicts  of  interest  to  declare.

Pericardite constritiva sob a perspetiva da tomografia computorizada cardíaca

Repositório Comum

Document downRev Port Cardiol. 2012;31(12):835--836Revista Portuguesa deCardiologiaPortuguese Journal of Cardiologywww.revportcardiol.orgIMAGE IN CARDIOLOGYConstrictive  pericarditis:  Insights  from  cardiac  computedtomographyPericardite  Constritiva  sob  a  perspetiva  da  tomograﬁa  computorizadacardíacaSílvia Ribeiroa,∗, Nuno Bettencourtb, Pedro Van Zellerc, Daniel Leiteb,Mónica  Carvalhob, Vasco Gama Ribeiroba Servic¸o  de  Cardiologia,  Hospital  de  Braga,  Braga,  Portugalb Servic¸o  de  Cardiologia,  Centro  Hospitalar  de  Vila  Nova  de  Gaia/Espinho,  Vila  Nova  de  Gaia,  Portugalc Servic¸o  de  Cardiologia,  Hospital  de  São  João,  Porto,  PortugalReceived  10  May  2012;  accepted  27  May  2012loaded from http://http://www.elsevier.pt, day 14/12/2012. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.Available  online  20  November  2012avddcrwcteConstrictive  pericarditis  is  a  rare  disease,  usually  theresult  of  long-standing  pericardial  inﬂammation  leading  topericardial  scarring  with  thickening,  ﬁbrosis,  and  calciﬁca-tion.  The  most  frequent  causes  are  mediastinal  radiation,chronic  idiopathic  pericarditis,  cardiac  surgery,  and  tuber-culous  pericarditis.  Nearly  9%  of  patients  with  acutepericarditis  for  any  reason  go  on  to  develop  constrictivephysiology.We  report  the  case  of  a  52-year-old  man  with  a  history  ofacute  pericarditis  30  years  ago,  with  a  three-year  evolutionof  fatigue,  dyspnea  and  palpitations.  Physical  examina-tion  revealed  jugular  venous  distension  and  hepatomegalyand  a  pericardial  knock  was  audible  on  cardiac  ausculta-tion.  The  12-lead  electrocardiogram  revealed  atrial  ﬂutter∗ Corresponding author.E-mail address: silviamartinsribeiro@gmail.com (S. Ribeiro).ppp0870-2551/$  –  see  front  matter  ©  2012  Sociedade  Portuguesa  de  Cardiologhttp://dx.doi.org/10.1016/j.repc.2012.05.013nd  the  transthoracic  echocardiogram  showed  distorted  leftentricular  geometry.  Cardiac  computed  tomography  (CT)emonstrated  pericardial  thickening  and  extensive  pericar-ial  calciﬁcation  (Figure  1A,B  and  C),  mostly  mid-cardiac,ausing  distortion  of  left  ventricular  morphology.  Markedestriction  to  diastolic  ventricular  ﬁlling  was  observed,ith  diastolic  apical  dilatation  (Figure  1D  and  E).  Cardiacatheterization  showed  ventricular  pressure  waveforms  withhe  classic  dip-and-plateau  physiology  and  equalization  ofnd-diastolic  pressures  of  both  ventricles,  compatible  withericardial  constriction.This  case  highlights  the  role  of  cardiac  CT  as  an  appro-riate  imaging  technique  for  the  diagnosis  of  constrictiveericarditis.ia  Published  by  Elsevier  España,  S.L.  All  rights  reserved.836  S.  Ribeiro  et  al.Figure  1  Multidetector  computed  tomography  post-processed  volume  rendered  images  (A,  B  and  C)  showing  the  thickened  andcalciﬁed pericardium  and  its  relations  with  the  coronary  arteries  and  cardiac  chambers.  Maximum  intensity  projection  images  inlong- (D)  and  short-axis  (E)  views  in  different  phases  of  the  cardiac  cycle  illustrate  restricted  myocardial  movement  and  diastolica adia(EPdaCdRdConﬂicts  of  interestDocument downloaded from http://http://www.elsevier.pt, day 14/12/2012. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.pical dilatation.  Tube  current  modulation  was  used  to  reduce  rnote differences  in  image  quality  in  systole  and  diastole).thical disclosuresrotection  of  human  and  animal  subjects.  The  authorseclare  that  no  experiments  were  performed  on  humans  ornimals  for  this  investigation.onﬁdentiality  of  data.  The  authors  declare  that  no  patientata  appear  in  this  article.Ttion  exposure,  with  full  current  applied  only  in  diastolic  phasesight  to  privacy  and  informed  consent.  The  authorseclare  that  no  patient  data  appear  in  this  article.he  authors  have  no  conﬂicts  of  interest  to  declare.

http://comum.rcaap.pt/bitstream/10400.26/3497/1/Constrictive%20pericarditis.pdf

Pericardite constritiva sob a perspetiva da tomografia computorizada cardíaca

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