Leivaditis Vasileios, Ayed Sofien, Özsoy Ece, Lausberg Henning, Papatriantafyllou Athanasios, Mulita Francesk, Baikoussis Nikolaos G, Windmüller Volker, Dahm Manfred
Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, DEU.
Department of Cardiology, Westpfalz-Klinikum, Kaiserslautern, DEU.
Cureus. 2025 Mar 30;17(3):e81449. doi: 10.7759/cureus.81449. eCollection 2025 Mar.
Constrictive pericarditis (CP) is a rare but serious condition characterized by pericardial fibrosis and impaired ventricular filling, often resulting in progressive heart failure. Infectious pericarditis, particularly purulent forms, is a severe etiology requiring early recognition and intervention. A 64-year-old male with a history of pericarditis presented with worsening dyspnea and signs of right heart failure. Imaging revealed a thickened, fibrotic pericardium with mild effusion, while cardiac catheterization confirmed CP with equalized diastolic pressures and a dip-plateau phenomenon. Given his clinical deterioration, he underwent subtotal pericardiectomy with pericardial reconstruction. Intraoperatively, severe adhesions were noted, necessitating extensive pericardial resection. The patient showed rapid postoperative improvement, with a resolution of heart failure symptoms and normalization of right ventricular function. This case highlights the importance of timely diagnosis and surgical intervention in CP following infectious pericarditis. Pericardiectomy remains the definitive treatment, with early recognition being key to optimizing patient outcomes.
缩窄性心包炎（CP）是一种罕见但严重的疾病，其特征为心包纤维化和心室充盈受损，常导致进行性心力衰竭。感染性心包炎，尤其是脓性形式，是一种严重病因，需要早期识别和干预。一名有过心包炎病史的64岁男性出现呼吸困难加重和右心衰竭体征。影像学检查显示心包增厚、纤维化并伴有少量积液，而心导管检查证实为缩窄性心包炎，舒张期压力均衡且有下陷-高原现象。鉴于其临床病情恶化，他接受了心包次全切除术并进行心包重建。术中发现严重粘连，需要广泛的心包切除。患者术后迅速好转，心力衰竭症状消失，右心室功能恢复正常。该病例强调了感染性心包炎后缩窄性心包炎及时诊断和手术干预的重要性。心包切除术仍然是决定性的治疗方法，早期识别是优化患者预后的关键。
