This case demonstrates that nonpericardial inflammatory tissue can cause cardiac constriction after pericardiectomy, which may be successfully treated with steroid therapy.
Post-pericardiectomy constriction from nonpericardial inflammation may respond to steroids; single case leaves open broader applicability versus reoperation.
A 13-year-old boy with active tuberculous constrictive pericarditis underwent complete pericardiectomy together with antituberculous therapy and a short course of steroids. Six weeks following the surgery, he was seen with clinical and hemodynamic findings of recurrent pericardial constriction, presumably due to an inflammatory collection around the heart. Symptoms gradually resolved within six months with resumption of steroid therapy. Repeat hemodynamic study showed normal hemodynamics. The case demonstrates the production of cardiac constriction by nonpericardial inflammatory tissue and the possible benefits of steroid therapy in the treatment of tuberculous constrictive pericarditis.
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Kashani et al. (1983) studied this question.
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