Diseases of the pericardium: morphologic study of surgical specimens from 35 patients

[The role of multimodality imaging in the diagnosis of constrictive pericarditis]

Constrictive pericarditis is a rare heart disease. The diagnosis remains a challenge. In fact, this illness can mimic restrictive cardiomyopathy. Echo-Doppler evaluation helps to establish the diagnosis of constriction; however, this technique is limited in its ability to image the entire pericardium because of its limited acoustic windows by air or bone of thorax. In addition, it is an operator-dependent exploration. Scanner and magnetic resonance imaging provide a large field of view and excellent images, showing the increased pericardial thickness and septal motion abnormalities. This review will consider the emerging role of these imaging modalities in the constrictive pericarditis diagnosis.

[Chronic constrictive pericarditis in African children: report of a case]

The chronic constrictive pericarditis is a rare affection, with multiple etiologies and concerning especially the adult. We report a case of chronic constrictive pericarditis in an African child in whom no etiology was found. A review of the literature raises the characteristics of chronic constrictive pericarditis for a better therapeutic management.

Surgical pathology of the parietal pericardium: a study of 344 cases (1993-1999)

Among 344 cases with surgically resected parietal pericardium, ages ranged from 1 to 87 years (mean, 55), and 64% were male. Causes of pericardial disease included neoplastic (33%), idiopathic (30%), iatrogenic (23%), and others (14%). Pericardial constriction (Group 1) represented the largest group (143 cases, 76% male). Maximal pericardial thickness was 1-17 mm (mean, 4). Fibrotic thickening occurred in 96%. Chronic lymphoplasmacytic inflammation affected 73% (mild or moderate in 97%). Calcification was uncommon (gross in 28%, microscopic in 8%), and granulomas were rare (4%, none tubercular). Constriction was idiopathic in 49% and iatrogenic (postpericardiotomy or postirradiation) in 41%. Neoplasms and cysts (Group 2) represented the second largest group (96 cases). Among 43 cases with secondary pericardial involvement, carcinomas accounted for 53% and lymphomas 21%. Forty cases (Group 3) had pericardial effusions (75% chronic), which were idiopathic in 28% and postpericardiotomy in 23%. Thirty-three cases (Group 4) had acute or recurrent pericarditis clinically, which was idiopathic in 70%. Lastly, 32 cases (Group 5) had pericardial resection for conditions unrelated to primary pericardial disease. In conclusion, pericardial constriction tended to be nontubercular (100%), nongranulomatous (96%), idiopathic or iatrogenic (90%), and noncalcific (64%), and it could occur with normal pericardial thickness (4%). Because considerable overlap in the gross and microscopic features existed among cases with noncalcific pericardial constriction (Group 1), pericardial effusions (Group 3), and pericarditis (Group 4), clinical information was necessary to provide an accurate clinicopathologic interpretation.

Constrictive calcific pericarditis following coronary arterial bypass surgery

A case of postsurgical constrictive calcific pericarditis is reported. The unusual features of this case are the short interval (two months) from surgery to the development of pericarditis and the involvement of the coronary arterial grafts, resulting in tearing of the vessels and the death of the patient during decortication.