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PubMed1979

[Constrictive pericarditis and rheumatoid arthritis].

Pericarditis is the commonest cardiac manifestation of rhumatoid arthritis. It is often clinically latent but it may evolve to constriction or less often to tamponade. The case presented is of a 60 year-old woman with a 5 year history of seropositive nodular rhumatoid arthritis in whom bilateral pleural effusions and constrictive pericarditis were observed after sudden termination of corticotherapy. She was treated successfully by pericardectomy. This complication is far from being exceptional (55 cases already reported). It justifies a systematic search for pericarditis in rhumatoid arthritis, especially by echocardiography.

Arthritis, Rheumatoid↗
PubMed2001

[The role of Doppler echocardiography in chronic constrictive pericarditis].

Constrictive péricarditis (CCP) is a rare but serious disease. It still poses diagnostic difficulties. The purpose of our work is to study the contribution of the echocardiographic Doppler in the diagnosis of the CCP. The authors report six cases of CCP proven after surgery. Study by ultrasound Doppler of intracardiac blood flow and their respiratory variations showed the existence of abnormalities. The decrease of 25% of the mitral E wave in inspiration compared to the value observed in expiration, the increase of 100% of the ebb in sus hépatic vein in expiration and the modifications of the flux in pulmonary insufficiency are the most reliable signs for the diagnosis of the CCP. This method seems so interesting for the diagnosis and to estimate the degree of constriction of the CCP.

Adult↗
PubMed2001

Pericardiectomy for constrictive pericarditis: is prolonged inotropic support a bad omen?

Sixty-seven patients who underwent pericardiectomy for constrictive pericarditis at JIPMER, Pondicherry between 1987 and 1998 were the subjects of the study. Pre-operatively 70% of cases were in the New York Heart Association classes III and IV categories with clinical signs suggestive of constriction ie, raised jugular venous pressure in 99%, pleural effusion in 77%, pedal oedema in 61% and ascites in 55% of the cases. Seventy-five per cent of the cases underwent pericardiectomy through a median sternotomy and the rest via left anterolateral thoracotomy. Low cardiac output was evidenced in 70% of cases postoperatively which was managed by early institution and prolonged use of inotropes. There was 9% mortality especially in the early part of the experience. Tuberculous pathology was confirmed histologically in 57% cases. Sixty-three per cent of cases are presenting in follow-up in New York Heart Association class I. Prolonged use of inotropes instituted early in postoperative period is recommended to prevent postoperative ventricular dysfunction with adrenaline being the preferred inotrope. It is concluded that postoperative New York Heart Association class and long term survival were not significantly influenced by pre-operative New York Heart Association class, operative approach or peri-operative low cardiac output syndrome requiring prolonged inotropic support.

Adolescent↗
PubMed2002

Reversible subacute effusive-constrictive pericarditis after correction of double-chambered right ventricle: a case report.

A 15-year-old girl developed subacute constrictive pericarditis following successful surgical repair of double-chambered right ventricle. Two weeks after surgery, the patient had massive pericardial effusion, which acutely progressed to constrictive pericarditis with the symptoms of cardiac tamponade. Further surgery was necessary to resect the parietal pericardium. No blood transfusion was required for this patient, who was a Jehovah's Witness. She was doing well 9 months after the second operation, with residual pericardium of normal thickness.

Adolescent↗
PubMed1975

[Myogenic constriction of myocardial arterial vessels following an increase in the pulsations of coronary perfusion pressure].

In isolated cat hearts, increase of coronary pulse pressure without change of the mean coronary perfusion pressure was followed by constriction of coronary arteries. The analysis of data eliminated extravascular (contractile activity of the heart, tissue pressure) and metabolic factors as a possible cause of the coronary arterial constriction. This leaves out that the observed reaction of myocardial vessels was a result of the coronary arterial smooth muscle contraction in response to the distending action of the increased pulse pressure.

Animals↗
PubMed2002

Constrictive pericarditis--a rare but important cause of recurrent cardiac failure: a case report.

Constrictive pericarditis (CP) is an uncommon cardiac disease which is often difficult to diagnose because of its vague and myriad clinical presentations. We report a case of a middle-aged lady who had non-specific symptoms and signs for six years before she was eventually diagnosed to have idiopathic constrictive pericarditis. An awareness and understanding of this condition is important, as it is a progressive condition and the likelihood of cure depends very much on its early identification and treatment.

Adult↗
PubMed2003

Cough syncope from constrictive pericarditis: a case report.

Loss of consciousness associated in some people with coughing is likely due to the hemodynamic changes induced by this exaggerated Valsalva manoeuvre. Cough syncope classically occurs in people with obstructive pulmonary disorders and it is unusual to find a specific correctable lesion precipitating it. A previously healthy man who developed tussive syncope in association with constrictive pericarditis and subsequently was cured by pericardiectomy is described. Although cough is a recognized feature of this cardiovascular condition, associated cough syncope has not previously been reported. However, the hemodynamic changes induced by constriction of cardiac filling understandably may further reduce cerebral perfusion during coughing. Not only does this case present a novel cause of this interesting syncopal syndrome, but it supports the basic pathophysiology thought to underlie it.

Cough↗
PubMed2003

Constrictive tuberculous pericarditis: case report and review of the literature.

Constrictive pericarditis is a rare disease characterized by the encasement of the heart by a rigid, non-pliable pericardium, with impaired diastolic filling of the ventricles. Its etiology is often unclear (42%), but is frequently associated with viral infection and tuberculosis, especially in developing countries. In this article the authors present the case report of a 28 year-old black woman, born and resident in Angola, with a history of tuberculosis, admitted to our hospital with global heart failure. After investigation a diagnosis of constrictive tuberculous pericarditis was established and the patient underwent pericardiectomy. Clinical features and radiologic, electrocardiographic, echocardiographic, computed tomography, nuclear magnetic resonance imaging and hemodynamic findings are discussed. This case illustrates the importance of early pericardiotomy before the appearance of pericardiectomy before end-stage pericardial fibrosis and subsequent increased possibility of an adverse postoperative outcome.

Adult↗
PubMed1992

Effects of FK224, a novel compound NK1 and NK2 receptor antagonist, on airway constriction and airway edema induced by neurokinins and sensory nerve stimulation in guinea pigs.

FK224 (N-[N2-[N-[N-[N-[2,3-didehydro-N-methyl-N-[N-[3-(2- penthylphenyl)-propionyl]-L-threonyl]tyrosyl]-L-leucynyl]-D- phenylalanyl]-L-allo-threonyl]-L-asparaginyl]-L-serine-nu-lactone) is a novel neurokinin (NK) antagonist that exhibits selectivity for NK1 and NK2 receptors. The effects of FK224 on airway constriction and airway edema induced by NKs and nerve stimulation have been investigated in guinea pigs. FK224 inhibited the contraction of isolated guinea pig trachea induced by substance P (SP, 10(-8) M), NKA (10(-9) M) and NKB (10(-8) M) in a concentration-dependent manner, and the IC50 values were 2.6 x 10(-6), 1.3 x 10(-6) and 2.3 x 10(-7) M, respectively. Tracheal contraction induced by histamine and acetylcholine was not affected by FK224, suggesting a specific effect on NK-mediated responses. FK224 also inhibited the atropine-resistant contraction of isolated guinea pig bronchi induced by electrical field stimulation with an IC50 value of 3.5 x 10(-6) M. In in vivo experiments, FK224 given i.v. inhibited SP (13.5 micrograms kg-1)-, NKA (1.1 micrograms kg-1)- and capsaicin (3.1 micrograms kg-1)-induced airway constriction in guinea pigs with ED50 values of 0.39 mg kg-1, 0.36 mg kg-1 and 1.1 mg kg-1, respectively. FK224 also inhibited SP (1.3 micrograms kg-1)-, NKA (11 micrograms kg-1)- and capsaicin (100 micrograms kg-1)-induced airway edema with ED50 values of 0.14 mg kg-1, 0.29 mg kg-1 and 0.30 mg kg-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

[Constrictive pericarditis due to asbestos exposure].

INTRODUCTION: Constrictive pericarditis is a rare complication of asbestos exposure and few cases have been reported in the literature. CASE REPORT: We report two cases of constrictive pericarditis in subjects previously exposed to asbestos. The first case, a 62 years old man, had occupational asbestos exposure whilst working for seven years in an electric plant 23 years before the diagnosis. The second case, a 76 years old man, had worked 21 years as a lagger up until 20 years before. The initial presentation in both cases was of sub-acute right heart failure. Both underwent pericardectomy which revealed pericardial thickening due to collagen fibrosis. Both patients died, one and five years respectively after surgery. Eight other cases of pericardial effusion and/or thickening, some with calcification, have been reported in association with previous asbestos exposure. Most of these cases had coexisting pleural lesions. CONCLUSIONS: As the prognosis is guarded (three of the eight reported cases died), making an early diagnosis is desirable.

Aged↗
PubMed2003

Constrictive pericarditis following cat-scratch disease in a 12-year-old female: a rare association.

We are reporting an unusual case of cat-scratch disease in a young adolescent girl presenting with recurrent ascites. The illness started with nonspecific symptoms followed by ascites and an axillary lymph node enlargement. She had recurrent ascites for 18 months associated with constrictive pericarditis. Following pericardiectomy, she had a resolution of ascites and was back to her normal life. This is a first documented report of a constrictive pericarditis following cat scratch diseases in English literature.

Cat-Scratch Disease↗
PubMed2004

[Total colectomy with simultaneous ileorectostomy in severe nonspecific ulcerative colitis complicated by constriction of the rectum].

Total colectomy with a one-stage ileorectostomy was fulfilled in 72 patients (67 children and 5 adult patients) with severe nonspecific ulcerative colitis by the method developed by the author. In 8 of the patients there was constriction of the rectum which required transanal finger bougieurage during the operation. None of the 72 patients had incompetence of the anastomosis. Follow-up observations during many years showed a rather high effect of the operation including the patients who had constriction of the rectum.

Adult↗
PubMed2004

A long-term analysis of the spinal somatosensory evoked potential of rats with sciatic constriction injury.

BACKGROUND: This study was undertaken to evaluate the long-term effect of a peripheral neuropathic pain model, chronic constriction injury (CCI) of the sciatic nerve, through analyses of electrophysiologic change, sciatic nerve function, and pain behavior. METHODS: CCI of the sciatic nerve was induced in twelve rats as described by Bennett and Xie. Three parameters were monitored: spinal somatosensory evoked potential (SSEP) elicited by supramaximal stimulation of the posterior tibial nerve and recorded from the thoracolumbar junctional space; thermal hyperalgesia assessed by measuring paw withdrawal latency (PWL); and sciatic function index (SFI). All the values of these parameters were obtained before the CCI procedure (day 1 as a preoperative baseline, and again on days 5, 12, 19, 26, 33, 47, 61, 75, and 89). SSEP was also measured 3 hr after the CCI operation. Data were also obtained from contralateral limbs. RESULTS: All rats with CCI developed thermal hyperalgesia on day 5, as indicated by a significant reduction in PWL in the CCI limbs and a deterioration of the SFI compared with baseline values. These effects persisted to day 89. In the electrophysiologic study, 3 hrs after the CCI operation, the amplitude significantly decreased and latency significantly increased in all SSEP recordings. The changes persisted and showed no further statistically significant deterioration or recovery. The data demonstrated that the major electrophysiologic change after a constriction injury was the loss of conduction ability across the injury site in the fast-conducting fibers, but in the slow-conducting fibers the conduction ability was still preserved, which occurred immediately after the operation and persisted consistently for 89 days in the rats with behavior manifestations of neuropathic pain. CONCLUSIONS: Our findings suggest that SSEP is simple to obtain and sensitive in the acute phase of electrophysiological changes, but is limited for long-term evaluation after CCI.

Animals↗
PubMed2005

Differentiating constrictive pericarditis from restrictive cardiomyopathy.

Constrictive pericarditis and restrictive cardiomyopathy are 2 forms of diastolic dysfunction with similar presentation but different treatment options. Whereas constrictive pericarditis has the potential of being cured with pericardiectomy, restrictive cardiomyopathy is usually incurable. It is therefore crucial to differentiate between the 2 disorders. In the last few years, new diagnostic techniques have become available to differentiate these causes of diastolic dysfunction from each other. This review provides a complete, in-depth comparison of the 2 disorders with regard to their symptoms and clinical features, etiology, pathophysiology, hemodynamics, echocardiographic presentation, and finally the different available management options.

Cardiomyopathy, Restrictive↗
PubMed2005

Surgical treatment of chronic constrictive pericarditis using an ultrasonic scalpel.

A 61-year-old male had complained of cough and dyspnea on effort, with right pleural effusion. Computed tomography demonstrated a calcific pericardium surrounding the entire heart, with thickening of 10 mm. Cardiac catheterization showed no coronary disease, but a dip-and-plateau of the pressure curve of both ventricles. We diagnosed congestive heart failure due to chronic constrictive pericarditis, and performed a subtotal pericardiectomy, using an Ultrasonic Scalpel through a median sternotomy combined with anterior left thoracotomy at the level of the fifth rib, without cardiopulmonary bypass (CPB). After the subtotal pericardiectomy, his postoperative recovery was uneventful and his functional status improved. We consider that our surgical technique is a useful method for treatment of chronic constrictive pericarditis, and advocate the use of the Ultrasonic Scalpel for a safe and easy pericardiectomy.

Chronic Disease↗
PubMed1980

Protein losing gastroenteropathy in constrictive pericarditis.

A case of constrictive pericarditis with PLGE is reported. It is the nineteenth case in the world literature. The fatal outcome is contributed to late diagnosis and refusal of surgery. It is possible that nine out of sixty eight cases of constrictive pericarditis have suffered from the same condition in a five year period in the same hospital. Early diagnosis is rewarding and could be achieved by a high index of suspicion and an outlook for the diagnostic markers.

Adult↗
PubMed2006

Chronic constrictive tuberculous pericarditis: risk factors and outcome of pericardiectomy.

OBJECTIVE: Data on long-term outcome of pericardiectomy are limited. This retrospective study aimed to investigate risk factors and early and late outcomes of pericardiectomy for constrictive tuberculous pericarditis. DESIGN: Seventy patients with chronic constrictive pericarditis who underwent pericardiectomy between January 1990 and August 2005 were reviewed for perioperative and long-term survival. RESULTS: Patients (49 males; median age 40 years) had a median duration of symptoms of 24 months (range 8-72) before surgery. Perioperative mortality was 8.6%. During follow-up (mean 66.4 +/- 56.4), late mortality rates at 5 and 10 years were 1.6% and 9.7%, respectively. The mean censored survival in all patients was 155.2 months (SEM 8.3, 95%CI 138.8-171.6). Readmission-free survival was 68.6% over 10 years (mean 125.4 months, SEM 10.3, 95%CI 105.2-145.6). Ascites and duration of symptoms were found to be predictors of perioperative mortality (P = 0.047 and 0.036, respectively). CONCLUSIONS: The optimal time of pericardiectomy is most important in its management. Total or near-total pericardiectomy should always be performed as early as possible.

Adolescent↗
PubMedDate not supplied

Imidazoline receptors in relaxation of acetylcholine-constricted isolated rat jejunum.

Since 20 years the concept of specific imidazoline receptors has remained controversial. The problem with imidazoline receptors is mostly due to their functional similarity to alpha-adrenoceptors. In this work, a pharmacodynamic model of isolated rat jejunum longitudinal muscle strips constricted with acetylcholine (Ach) was applied to separate functional properties of the two types of receptors. Relaxation of the preparation was measured as a function of concentration of 2-(benzofuranyl)-2-imidazoline (2-BFI), a specific imidazoline I2 receptor ligand, cirazoline, a potent I2 receptor ligand and alpha1-adrenoceptor agonist, phenylephrine, an agonist of alpha1-adrenoceptor, moxonidine, a ligand of I1 receptor, efaroxan, a ligand of I3 receptor and 5-bromo-6-(imidazoline-2-yl-amino)quinoxaline (UK14304), an agonist of alpha2-adrenoceptor. Next, the effects of a series of imidazoline-and/or alpha-adrenoceptor-binding drugs (prazosin, yohimbine, RS79948, RX821002, idazoxan and efaroxan) on the relaxation of the Ach-constricted rat jejunum strips, induced by 2-BFI, cirazoline or phenylephrine, were studied. The obtained results demonstrate the involvement of the postsynaptic imidazoline receptors in rat jejunum motility. These receptors are of I2 subtype and are linked to alpha-adrenoceptors of the predominantly alpha1 subtype. The alpha1 receptors dominate functionally over the I2 in the isolated rat jejnum. The proposed model might be useful in search for more specific new drugs.

Acetylcholine↗