Constrictive Pericarditis on Echocardiogram

A 55-year-old female marathon runner presents to clinic w/ 6-months of worsening breathlessness (half-marathon time increased by 30 m).  She had gained 15 kg and swollen legs. Exam showed BP 100/82, HR 74, JVP 15 cm ASA, Kussmaul's sign, marked pedal edema, and clear lungs.

We did a transthoracic echocardiogram to workup right-heart failure.  This showed a small‐to‐moderate circumferential pericardial effusion. Look at the thickness and brightness the epicardium. There were classic features of constrictive pericarditis:

(A) a dilated inferior vena cava with <50% respiratory variation, (B) a septal mitral annular e’ velocity of 9.5 cm/sec, (C) mild diastolic reversal of the hepatic vein with expiration not meeting diagnostic criteria (D) a leftward ventricular septal shift with inspiration and a diastolic septal shudder by M‐mode imaging of the ventricular septum. These findings suggest constrictive pericarditis.

- Omid Kiamanesh, MD @OKiamanesh

#Constrictive #Pericarditis #Echocardiogram #a4c #pocus #clinical #cardiology
Contributed by

Dr. Gerald Diaz
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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