A case of Effusive-Constrictive Chronic Pericarditis (and Pericardiectomy)

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A transthoracic echocardiogram was performed.
LV EDV= 84 ml; EF= 62 %. Mild LA dilatation. Estimated pulmonary systolic pressure= 33 mmHg.

Figure 4. 2D parasternal long axis
Figure 5. Color Doppler parasternal long axis
Figure 6. 2D parasternal short axis
Figure 7. 2D apical 4-chamber, right ventricle
Figure 8. 2D subcostal 4-chamber
Figure 9. Color Doppler apical 4-chamber, right upper pulmonary vein

The exam shows: normal LV dimensions, wall thickness and systolic function with mild posterior effusion (Fig 4 and 10); systolic flattening of the mitral leaflets without significant prolapse (Fig, 4) and with trace regurgitation with central origin and posterior direction (Fig. 5); mild LA dilatation (Fig. 4); right atrial dilatation, mild effusion lateral to the right heart chambers, signs of calcifications of the pericardium lateral to the RV (hyper-reflectivity and acoustic shadowing), and evident leftwards inspiratory motion of the interventricular septum (Figs 6-8 and 10); thickening and hyper-reflectivity of the pericardium infero-lateral to the RV (Fig. 8); marked respiratory variability of the right upper pulmonary vein flow (Fig. 9). The bright green line is the respiratory tracing.
Figure 9b. Dilatation and absent inspiratory collapse of the inferior vena cava.

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