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      Chronic Effusive Pericarditis and Chronic Constrictive Pericarditis

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          Abstract

          Chronic Pericarditis is inflammation that begins gradually, is long lasting and results in fluid accumulation in the pericardial space or thickening of the pericardium. The etiology is unknown but may be cancer, TB or hypothyroidism. Arrhythmias are common and seen in almost half the patients. The commonest arrhythmia is atrial fibrillation. Symptoms and signs are related to increased right atrial pressure and physical findings include elevated JVP and pericardial knock. Non surgical therapy consists mainly of no salt. Surgery cures about 85% of patients, however 5–15% of patients will die. Chronic effusive pericarditis occurs when there is persistent restriction of the visceral pericardium after pericardiocentesis.

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          Most cited references 5

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          Constrictive pericarditis in the modern era: novel criteria for diagnosis in the cardiac catheterization laboratory.

          This study sought to determine the clinical utility of a new catheterization criterion for the diagnosis of constrictive pericarditis (CP). The finding of early rapid filling and equalization of end-diastolic pressures obtained by cardiac catheterization are necessary for the diagnosis of CP, but these findings are also present in patients with restrictive myocardial disease (RMD). Enhanced ventricular interaction is unique to CP. High-fidelity intracardiac pressure waveforms from 100 consecutive patients undergoing hemodynamic catheterization for diagnosis of CP versus RMD were examined. Fifty-nine patients had surgically documented CP and comprised group 1; the remaining 41 patients with RMD comprised group 2. The ratio of the right ventricular to left ventricular systolic pressure-time area during inspiration versus expiration (systolic area index) was used as a measurement of enhanced ventricular interaction. There were statistically significant differences in the conventional catheterization criteria between CP and RMD, but the predictive accuracy of any of the criteria was <75%. The systolic area index had a sensitivity of 97% and a predictive accuracy of 100% for the identification of patients with surgically proven CP. The ratio of right ventricular to left ventricular systolic area during inspiration and expiration is a reliable catheterization criterion for differentiating CP from RMD, which incorporates the concept of enhanced ventricular interdependence.
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            Subacute effusive-constrictive pericarditis.

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              Subacute constrictive pericarditis with cardiac tamponade.

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                Author and article information

                Journal
                CVIA
                Cardiovascular Innovations and Applications
                CVIA
                Compuscript (Ireland )
                2009-8782
                2009-8618
                July 2020
                July 2020
                : 4
                : 4
                : 291-293
                Affiliations
                1University of Florida Medical School, Gainesville, FL, USA
                Author notes
                Correspondence: C. Richard Conti, MD, University of Florida Medical School, Gainesville, FL, USA, E-mail: conticr@ 123456medicine.ufl.edu
                Article
                cvia20190020
                10.15212/CVIA.2019.0020
                Copyright © 2020 Cardiovascular Innovations and Applications

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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