Gangwani Manesh Kumar, Mahmood Salman B, Hasan Fariha, Khan Javaid A
Medical College, The Aga Khan University, Karachi, PAK.
Department of Medicine, Hennepin County Medical Center.
Cureus. 2018 Apr 9;10(4):e2451. doi: 10.7759/cureus.2451.
Constrictive pericarditis is a rare presentation. We need a very high index of clinical suspicion to diagnose the disease. It most commonly presents secondary to tuberculosis (TB) in the developing world and post-radiation therapy in the developed world. Classically, it presents with symptoms of heart failure and as pericardial thickening or calcification on imaging studies. In hospital settings, constrictive pericarditis is not usually considered as a differential in patients presenting with pleural effusion. According to the literature, associated pleural effusions in cases of constrictive pericarditis could be left-sided. Herein, we present two unusual presentations of cases with bilateral pleural effusions. One of our cases developed constrictive pericarditis with concurrent active tuberculosis. This is a rare presentation because, normally, constrictive pericarditis is a late complication of tuberculosis. We suggest that when dealing with cases of bilateral pleural effusion, the etiology of constrictive pericarditis should be considered.
缩窄性心包炎是一种罕见的病症。我们需要高度的临床怀疑指数来诊断该病。在发展中国家，它最常见于继发于结核病（TB），而在发达国家则最常见于放射治疗后。典型地，它表现为心力衰竭症状以及影像学检查显示的心包增厚或钙化。在医院环境中，缩窄性心包炎通常不被视为胸腔积液患者的鉴别诊断之一。根据文献，缩窄性心包炎病例中相关的胸腔积液可能是左侧的。在此，我们展示两例双侧胸腔积液的不寻常病例。我们的其中一例并发活动性结核病发展为缩窄性心包炎。这是一种罕见的表现，因为通常情况下，缩窄性心包炎是结核病的晚期并发症。我们建议，在处理双侧胸腔积液病例时，应考虑缩窄性心包炎的病因。
