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Veil-Picard M, Rival G, Aupècle B, Laluc F, Maitre J, Seronde MF, Dalphin JC. [Unilateral transudative pleural effusion and constritive pericarditis]. Rev Mal Respir 2015; 32:58-65. [PMID: 25618206 DOI: 10.1016/j.rmr.2014.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 06/14/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Constrictive pericarditis is associated with thickening, fibrosis or inflammation of the pericardium which can lead to signs of right ventricle dysfunction. It is usually a chronic process which can present in a variety of ways. We present two cases of constrictive pericarditis discovered during the investigation of a left-sided pleural effusion. OBSERVATION The cases represent two sorts of constrictive pericarditis, chronic and due to pericardial effusions. Their common feature was an increase in dyspnoea and a new pleural effusion on the left side. Their difference lies in the presence of a thickened calcified pericardium in one case and the presence of a pericardial effusion in the other. In both cases, non-invasive investigation failed to diagnose any cardiac disease. The presence of constrictive pericarditis was confirmed by right heart catheterization. Treatment by subtotal pericardectomy was effective. CONCLUSION The thoracic manifestations of constrictive pericarditis are most commonly recurring bilateral pleural effusions. The mode of presentation may be an exudative, or transudative effusion. Unilateral pleural involvement, fibrosis, chylothorax or tumour like presentations may occur. A diagnosis of constrictive pericarditis should be considered in these clinical contexts and an examination of the pericardium performed. Cardiac catheterization can help in the differential diagnosis.
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Affiliation(s)
- M Veil-Picard
- Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France.
| | - G Rival
- Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France; Service de réanimation, centre hospitalier de Montélimar, 26200 Montélimar, France
| | - B Aupècle
- Service de chirurgie thoracique, CHU de Besançon, 25000 Besançon, France
| | - F Laluc
- Service de chirurgie thoracique, CHU de Besançon, 25000 Besançon, France
| | - J Maitre
- Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France
| | - M-F Seronde
- Service de cardiologie, CHU de Besançon, 25000 Besançon, France
| | - J-C Dalphin
- Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France
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Raissuni Z, Lachhab A, Haddour L, Doghmi N, Cherti M. [The role of multimodality imaging in the diagnosis of constrictive pericarditis]. Ann Cardiol Angeiol (Paris) 2014; 63:32-39. [PMID: 24210809 DOI: 10.1016/j.ancard.2013.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/02/2013] [Indexed: 06/02/2023]
Abstract
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.
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Affiliation(s)
- Z Raissuni
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc.
| | - A Lachhab
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| | - L Haddour
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| | - N Doghmi
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
| | - M Cherti
- Service de cardiologie B, hôpitaux universitaires de Rabat, Rabat, Maroc
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[Cardiac MRI: technology, clinical applications, and future directions]. Ann Cardiol Angeiol (Paris) 2013; 62:326-41. [PMID: 24035258 DOI: 10.1016/j.ancard.2013.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 08/12/2013] [Indexed: 11/23/2022]
Abstract
The field of cardiovascular MRI has evolved rapidly over the past decade, feeding new applications across a broad spectrum of clinical and research areas. Advances in magnet hardware technology, and key developments such as segmented k-space acquisitions, advanced motion encoding techniques, ultra-rapid perfusion imaging and delayed myocardial enhancement imaging have all contributed to a revolution in how patients with ischemic and non-ischemic heart disease are diagnosed and treated. Actually, cardiac MRI is a widely accepted method as the "gold standard" for detection and characterization of many forms of cardiac diseases. The aim of this review is to present an overview of cardiac MRI technology, advances in clinical applications, and future directions.
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Lachhab A, Doghmi N, Zouhairi A, Seghrouchni A, Wahid FA, Boulahya A, Maazouzi W, Elfakir Y, Taoussi O, Amri R, Belhaj L, Haddour L, Cherradi R, Oukerraj L, Cherti M. Use of magnetic resonance imaging in assessment of constrictive pericarditis: a Moroccan center experience. Int Arch Med 2011; 4:36. [PMID: 22011375 PMCID: PMC3240823 DOI: 10.1186/1755-7682-4-36] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/19/2011] [Indexed: 12/02/2022] Open
Abstract
Background The diagnosis of constrictive pericarditis continues to be a clinical challenge. Magnetic resonance imaging provides excellent visualization of the pericardium. The aim of our study is to clarify the contribution of this non invasive exploration in the diagnosis of constrictive pericarditis in our center. Methods we conducted a prospective study over a period of two years, since 2008, covering a series of patients (n = 11), mean age 44 ± 15 years, in whom constrictive pericarditis was suspected clinically and on transthoracic echocardiography. We studied its characteristics on magnetic resonance imaging. Results Magnetic resonance imaging confirmed the diagnosis showing pericardial thickening in all cases, measuring 8.2 +/- 2.6 mm on average, circumferential in 64%, and localized in 36%. The imaging data, particularly pericardial thickening and its topography, were confirmed by surgical exploration, and results were concordant in all cases. Conclusion Magnetic resonance imaging is a powerful tool to establish constrictive pericarditis diagnosis.
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Affiliation(s)
- Amal Lachhab
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
| | - Nawal Doghmi
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
| | | | - Anis Seghrouchni
- Department of Cardiovascular surgery, Military Hospital, Rabat, Morocco
| | - Fouad Amal Wahid
- Department of Cardiovascular surgery, Military Hospital, Rabat, Morocco
| | | | - Wajih Maazouzi
- Department of Cardiovascular Surgery, Ibn Sina Hospital, Rabat, Morocco
| | | | - Omar Taoussi
- Department of Radiology, Agdal Clinic, Rabat, Morocco
| | - Rachida Amri
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
| | - Loubna Belhaj
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
| | - Laila Haddour
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
| | | | - Latifa Oukerraj
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
| | - Mohamed Cherti
- Department of Cardiology B, Maternity Hospital, Rabat, Morocco
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