Forma inusitada de Pericardite Crônica Constritiva Idiopática Unusual presentation of Idiophatic Chronic Constrictive Pericarditis

• Main Authors: Moacir Fernandes de Godoy, Fábio Barros de Francischi, Paulo Roberto Pavarino, Marcos Aurélio Barboza de Oliveira, Marcelo José Ferreira Soares, Domingo Marcolino Braile
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cirurgia Cardiovascular 2007-03-01
• Series: Brazilian Journal of Cardiovascular Surgery
• Subjects: Pericardite constritiva; Insuficiência cardíaca congestiva; Cardiomiopatia restritiva; Ecocardiografia; Pericarditis, constrictive; Heart failure, congestive; Cardiomyopathy, restrictive; Echocardiography
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382007000100005
• ISSN: 0102-7638; 1678-9741

Paciente masculino, 55 anos, com queixa progressiva há 1 ano e 8 meses. Estava com 160kg (habitual 95 kg), extremamente edemaciado, com ortopnéia. Trouxe exames ecocardiográficos normais e eletrocardiograma com inversão de onda T. Biópsia endomiocárdica afastou fibrose endomiocárdica ou cardiomiopatia restritiva, mas as curvas pressóricas eram típicas de processo restritivo. Novo ecocardiograma agora mostrou pericárdio bastante espesso. Indicada pericardiectomia, recebendo alta com remissão completa dos sintomas. O estudo anatomopatológico foi inespecífico, sendo a pericardite classificada como idiopática. O caso alerta para a necessidade de alto grau de suspeição de pericardite constritiva em pacientes com ascite volumosa sem causa aparente.<br>A 55-year-old male patient presented in our service with progressive dyspnea and ascitis beginning 1 year and 8 months previously. He weighed 160 kg (normal weight 95 kg), with ascitis and orthopnea. On admission he presented normal echocardiograms. An electrocardiogram showed diffuse inverted T waves. An endomyocardial biopsy was not elucidative. A new echocardiogram confirmed a very thick pericardium. Surgical pericardial resection was indicated. The postoperative period was uneventful with complete remission of symptoms. The anatomopathological analysis was normal. The pericarditis was classified as idiopathic. This case is a warning for the need of much suspicion in patients with apparent causeless voluminous ascitis.