Djafarou Boubacar Raynatou, Mohamed Aden Fatouma, Ekhya Amoumoune Fatima, Diallo Thierno Hamidou, Faraj Raid, Baba Oum El M, El Khadir Loubna, Atteyeh Mustapha, Tahirou Oumarou Halima, Sow Salif, Mouine Najat, Asfalou Ilyasse, Moutakiallah Younes, Benyass Aatif
Faculty of Medecine an Pharmacy, Mohamed V University, Rabat, Morocco.
Cardiology Center, Mohammed V Military Training Hospital, Rabat, Morocco.
Radiol Case Rep. 2024 Sep 14;19(12):5882-5887. doi: 10.1016/j.radcr.2024.08.016. eCollection 2024 Dec.
Chronic constrictive pericarditis is a pericardial affection that causes a severe impairment of myocardial compliance. Among its many etiologies, tuberculosis is the most common cause, mainly in developing countries. Multimodal imaging methods are essential tools for guiding diagnosis. We present the case of a 64-year-old man with no past medical history who presented with dyspnea stage II of NYHA and right heart failure. At admission, he was stable, with normal blood pressure and a normal heart rate. His ECG showed a low voltage of QRS complexes. Transthoracic echocardiography revealed significant pericardial thickening enveloping the ventricles, with significant respiratory flow variation. A thoracic CT scan and cardiac MRI confirmed the presence of pericardial thickening and calcifications. The patient underwent beat-heart pericardial decortication. The anatomopathological examination of the surgical piece revealed Mycobacterium tuberculosis. The postoperative check-up after 6 months showed good clinical and echocardiographic evolution.
慢性缩窄性心包炎是一种导致心肌顺应性严重受损的心包疾病。在其众多病因中,结核病是最常见的病因,主要发生在发展中国家。多模态成像方法是指导诊断的重要工具。我们报告一例64岁男性患者,既往无病史,出现纽约心脏协会(NYHA)II级呼吸困难和右心衰竭。入院时,他病情稳定,血压正常,心率正常。他的心电图显示QRS波群低电压。经胸超声心动图显示心室周围心包显著增厚,伴有显著的呼吸血流变化。胸部CT扫描和心脏磁共振成像证实存在心包增厚和钙化。患者接受了心脏不停跳心包剥脱术。手术标本的解剖病理学检查发现结核分枝杆菌。6个月后的术后检查显示临床和超声心动图有良好的进展。