Chronic active myocarditis simulating constrictive pericarditis-like findings: report of a case.

A 34-year-old female with rhythm disturbance and characteristic hemodynamic features of constrictive pericarditis is presented. A left ventricular wall open needle biopsy revealed mild mononuclear cell infiltration suggestive of myocarditis. The patient died of intractable heart failure seven years later. The autopsy revealed left and right ventricular dilatation, multiple foci of mononuclear cell infiltration, and diffuse replacement fibrosis in 31%, 13% and 14% of the areas of the left ventricular free wall, ventricular septum, and right ventricular wall, respectively, predominantly in the inner layers (68%). The pericardium was intact. These clinically constrictive pericarditis-like findings are considered to be secondary to chronic active myocarditis.