CONSTRICTIVE PERICARDITIS: AN OVERLOOKED CAUSE OF ASCITES

Öz

Aims: Constrictive pericarditis is a well-known but unusual and rare cause of ascites. The diagnosis of constrictive pericarditis in most patients who have chronic ascites is challenging. We aimed to present a patient with constrictive pericarditis with chronic ascites and pericardial calcifications seen in chest radiography. Case Report: A 66-year-old male patient presented to the emergency room of Trakya University School of Medicine. The patient had abdominal swelling and ascites for the last 5 years and underwent large-volume paracentesis in his previous emergency admissions. After the electrocardiography of the patient, he was directed to the cardiology department for further examinations. The chest radiography revealed significant pericardial calcifications. Following imaging procedures confirmed radiological findings, and the patient was diagnosed with constrictive pericarditis. Furthermore, his cardiac catheterization findings were consistent with constrictive pericarditis. The patient was recommended to have a pericardiectomy operation and there was a significant reduction in the patient's symptoms after surgery. Conclusion: The absence of specific symptoms and resemblances of existing symptoms to liver disease make the early diagnosis of con- strictive pericarditis difficult. Physicians should consider constrictive pericarditis as a differential diagnosis when dealing with a patient who has chronic ascites.

Anahtar Kelimeler

• Constrictive pericarditis
• ascites
• pericardial disease

Kaynakça

1. 1. Fowler NO. Constrictive pericarditis: its history and current status. Clin Cardiol 1995;18(6):341-50.
2. 2. Welch TD, Oh JK. Constrictive pericarditis. Cardiol Clin 2017;35(4):539-49.
3. 3. Sengupta PP, Eleid MF, Khandheria BK. Constrictive pericarditis. Circ J 2008;72(10):1555-62.
4. 4. Barry M, Al-Muhaidb S, Fathala A. A case report of constrictive pericarditis: a forgotten cause of refractory ascites. Radiol Case Rep 2020;15(12):2565-8.
5. 5. Howard JP, Jones D, Mills P et al. Recurrent ascites due to constrictive pericarditis. Frontline Gastroenterol 2012;3(4):233-7.
6. 6. George TJ, Arnaoutakis GJ, Beaty CA et al. Contemporary etiologies, risk factors, and outcomes after pericardiectomy. Ann Thorac Surg 2012;94(2):445-51.
7. 7. Miranda WR, Oh JK. Constrictive pericarditis: a practical clinical approach. Prog Cardiovasc Dis 2017;59(4):369-79.
8. 8. Griffin BP, Topol EJ. Pericardial disease. Manual of Cardiovascular Medicine. 2nd ed. Philadelphia, Pennsylvania: Lippincott Williams and Wilkins; 2004.p.372-96.

9. 9. Chang SA, Oh JK. Constrictive pericarditis: a medical or surgical disease? J Car- diovasc Imaging 2019;27(3):178-86.
10. 10. Welch TD. Constrictive pericarditis: diagnosis, management and clinical out- comes. Heart 2017;104(9):725-31.
11. 11. Ling LH, Oh JK, Breen JF et al. Calcific constrictive pericarditis: is it still with us? Ann Intern Med 2000;132(6):444-50.
12. 12. Welch TD, Ling LH, Espinosa RE et al. Echocardiographic diagnosis of constric- tive pericarditis: Mayo Clinic criteria. Circ Cardiovasc Imaging 2014;7(3);526-34.
13. 13. Syed FF, Schaff HV, Oh JK. Constrictive pericarditis—a curable diastolic heart failure. Nat Rev Cardiol 2014;11(9):530-44.