Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, Osaka, Japan.
Department of Cardiology, Japan Community Healthcare Organization (JCHO) Osaka Hospital, Osaka, Japan
BMJ Case Rep. 2021 Mar 16;14(3):e240235. doi: 10.1136/bcr-2020-240235.
A 59-year-old man presented with exertional dyspnoea and pretibial oedema that had lasted 6 months. He was referred to our hospital with suspected constrictive pericarditis (CP). Several examinations, including CT, echocardiography and cardiac catheterisation, indicated heart failure associated with CP that had been induced by trauma 13 years prior. The CP and heart failure were unresponsive to medical treatment, therefore, a surgical pericardiectomy was performed, which is considered the only definitive treatment. Pathological examination of the resected pericardium revealed a fatty texture and dense fibrous connective tissues, which are associated with old haemorrhage and focal calcification. The patient's symptoms were improved to New York Heart Association Class I, and his peripheral oedema disappeared 6 months after leaving hospital.
一位 59 岁男性因劳力性呼吸困难和胫前水肿就诊，这些症状已持续 6 个月。他因疑似缩窄性心包炎（CP）被转至我院。多项检查，包括 CT、超声心动图和心导管检查，均提示存在由 13 年前创伤引起的 CP 相关心力衰竭。CP 和心力衰竭对药物治疗无反应，因此进行了手术心包切除术，这被认为是唯一的根治性治疗方法。切除的心包组织病理学检查显示出脂肪质地和致密的纤维结缔组织，这与陈旧性出血和局灶性钙化有关。患者的症状改善至纽约心脏协会（NYHA）心功能分级 I 级，出院后 6 个月其外周水肿消失。
