Early-onset post-cardiotomy severe constrictive pericarditis: a case report

Figures

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  Figure 1. Chest roentgenograph demonstrating pleural effusions without pericardial calcification.

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  Figure 2. 12-Lead electrocardiogram demonstrating sinus rhythm without acute abnormalities. Note that the low peripheral lead voltages, which is one of the non-specific signs of constrictive pericarditis on electrocardiogram.

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  Figure 3. Transthoracic echocardiogram from the apical four-chamber view revealed respirophasic septal motion, seen at end-diastolic (A) inspiration and (B) expiration, and altered inflow velocities at the (C) mitral valve and (D) tricuspid valve.

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  Figure 4. Right and left heart catheterization pressure measurements demonstrated (A) elevated right atrial pressure with rapid x and y descents, (B) square root sign, (C) equalization of left ventricular and right ventricular end-diastolic pressures, (D) discordance in ventricular pressures during respiration.

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  Figure 5. On T2 cardiac magnetic resonance imaging, thickened, fibrous crescent-shaped pericardial mass adjacent to the anterolateral, lateral, and inferolateral walls, measuring up to 24 mm (A). Phase Sensitive Inversion Recover sequences with gadolinium contrast demonstrated an 8 mm thick pericardium with up to 16 mm of pericardial fluid around the left ventricle (B). Evident interventricular dependence on free breathing module, indicative of contrictive physiology (Supplementary material online, Video).