Key result
Endomyocardial biopsy helps avoid unnecessary surgery when differentiating RCM from CP.
Why the study?
The differentiation of restrictive cardiomyopathy from pericardial constriction remains a difficult clinical problem with poor discriminating value of individual diagnostic features.
How can restrictive cardiomyopathy be differentiated from constrictive pericarditis?
How can restrictive cardiomyopathy be differentiated from constrictive pericarditis?
Endomyocardial biopsy is a valuable tool to differentiate restrictive cardiomyopathy from constrictive pericarditis, potentially avoiding the high risks associated with diagnostic thoracotomy.
Endomyocardial biopsy may avert unnecessary thoracotomy; leaves open whether modern imaging refines noninvasive differentiation.
The differentiation of restrictive cardiomyopathy from pericardial constriction remains a difficult clinical problem. Although the historical, noninvasive, and hemodynamic and angiographic features discussed here provide poor discriminating value when considered individually, a combination of clues may suggest one diagnosis or the other. Endomyocardial biopsy affords the greatest hope of avoiding unnecessary surgical exploration. Thoracotomy continues, however, to be the gold standard by which to make the distinction, carrying with it significant risk in patients with underlying restrictive cardiomyopathy.
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Mark H. Schoenfeld (1990) conducted a review in Restrictive cardiomyopathy and constrictive pericarditis. Diagnostic evaluation (endomyocardial biopsy and thoracotomy) was evaluated. Endomyocardial biopsy affords the greatest hope of avoiding unnecessary surgical exploration, although thoracotomy remains the gold standard for differentiating the two conditions.
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