Event Title

The caged heart” – massive post traumatic pericardial calcification causing constrictive pericarditis

Location

Auditorium Pond Side

Start Date

26-2-2014 10:30 AM

Abstract

Introduction: Trauma to the chest wall can cause bleeding into the pericardium with subsequent inflammation and calcification resulting in constrictive pericarditis.

Case Report: Herein we are reporting an unusual case of a man who had chest wall trauma in childhood and presented to our hospital at age of 35 years with ascites, easy fatigability and lightheadedness. On examination, he had signs of right heart failure. His chest X-ray revealed massive pericardial calcification and echocardiogram showed extensive pericardial calcification, also embedding into the myocardium, along with constrictive physiology. After diagnosis of constrictive pericarditis, a pericardiectomy was performed showing large organized calcified hematoma.

Discussion: Blunt trauma to the chest wall may results in bleeding into the pericardium. Development of organized, calcified hematoma post trauma is rare complication, but a few case reports have been described in literature. In the review of literature, the time from injury to surgery ranged from 3 to 20 years. Our patient also presented after two decades after his initial injury.

Medical therapy is to decrease the symptoms of heart failure, but pericardiotomy and pericardial stripping is the main stay of treatment to relieve the constriction.

As this is a rare disease, the data regarding prognosis of the disease is relatively scanty. The degree of pericardial calcification has shown no effect on survival.

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Feb 26th, 10:30 AM

The caged heart” – massive post traumatic pericardial calcification causing constrictive pericarditis

Auditorium Pond Side

Introduction: Trauma to the chest wall can cause bleeding into the pericardium with subsequent inflammation and calcification resulting in constrictive pericarditis.

Case Report: Herein we are reporting an unusual case of a man who had chest wall trauma in childhood and presented to our hospital at age of 35 years with ascites, easy fatigability and lightheadedness. On examination, he had signs of right heart failure. His chest X-ray revealed massive pericardial calcification and echocardiogram showed extensive pericardial calcification, also embedding into the myocardium, along with constrictive physiology. After diagnosis of constrictive pericarditis, a pericardiectomy was performed showing large organized calcified hematoma.

Discussion: Blunt trauma to the chest wall may results in bleeding into the pericardium. Development of organized, calcified hematoma post trauma is rare complication, but a few case reports have been described in literature. In the review of literature, the time from injury to surgery ranged from 3 to 20 years. Our patient also presented after two decades after his initial injury.

Medical therapy is to decrease the symptoms of heart failure, but pericardiotomy and pericardial stripping is the main stay of treatment to relieve the constriction.

As this is a rare disease, the data regarding prognosis of the disease is relatively scanty. The degree of pericardial calcification has shown no effect on survival.