Our Summary

This study looks at a condition known as constrictive pericarditis, which affects the pericardium - the thin, protective sac around the heart. The researchers wanted to see if a surgical procedure called pericardiectomy, where part or all of the pericardium is removed, can improve the condition. They used a type of imaging called speckle-tracking echocardiography to measure the movement and strain of the heart muscles.

The study included 83 patients who had constrictive pericarditis and underwent pericardiectomy. The patients’ heart function was measured before and after surgery and compared with 20 healthy volunteers.

The results showed that the heart’s movement and strain were different in patients with constrictive pericarditis compared to the healthy volunteers. After surgery, there was a significant change in the movement and strain of certain parts of the heart. Overall, the surgery led to an increase in the heart’s natural ‘swinging’ motion, indicating a loss of support from the removed pericardium.

The researchers conclude that removing the pericardium does change the mechanics of the heart. Further research is needed to understand whether these changes are beneficial or harmful to patients in the long term. This could help doctors make more informed decisions about the best treatment options for constrictive pericarditis.

FAQs

  1. What is constrictive pericarditis and how does it affect the heart?
  2. What is pericardiectomy and how does it improve constrictive pericarditis?
  3. What changes in heart mechanics were observed after a pericardiectomy, according to the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to follow the recommended post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and gradually increasing physical activity as advised by the healthcare team. It is important to communicate any new or worsening symptoms to your doctor promptly to ensure optimal recovery and overall health.

Suitable For

Patients with constrictive pericarditis who have symptoms such as shortness of breath, chest pain, fatigue, and fluid retention are typically recommended for pericardiectomy. Pericardiectomy may be considered for patients who do not respond to medical therapy or have severe symptoms that significantly impact their quality of life. Additionally, patients who have evidence of constriction on imaging studies such as echocardiography or cardiac MRI may also be candidates for pericardiectomy. It is important for patients to discuss the risks and benefits of pericardiectomy with their healthcare provider to determine if it is the best treatment option for their individual case.

Timeline

Before pericardiectomy:

  1. Patient presents with symptoms of constrictive pericarditis, such as shortness of breath, chest pain, fatigue, and swelling in the legs.
  2. Patient undergoes diagnostic tests, such as echocardiography and cardiac MRI, to confirm the diagnosis.
  3. Treatment with medications, such as diuretics and anti-inflammatory drugs, may be attempted to manage symptoms.
  4. If symptoms are severe and do not improve with medication, surgery may be recommended.

After pericardiectomy:

  1. Patient undergoes pericardiectomy surgery to remove part or all of the pericardium.
  2. Recovery in the hospital typically lasts 5-7 days, with monitoring of symptoms and heart function.
  3. Patients may experience temporary chest pain, fatigue, and limited mobility post-surgery.
  4. Follow-up appointments and tests, such as echocardiography, are scheduled to monitor the heart’s function and assess the success of the surgery.
  5. Over time, symptoms of constrictive pericarditis may improve or resolve completely, leading to better quality of life for the patient.

What to Ask Your Doctor

  1. What is constrictive pericarditis and why is pericardiectomy recommended for this condition?
  2. How will pericardiectomy improve my symptoms and overall heart function?
  3. What are the potential risks and complications associated with pericardiectomy?
  4. How long is the recovery period after pericardiectomy and what can I expect during this time?
  5. Will I need any follow-up tests or monitoring after the surgery?
  6. Are there any lifestyle changes or medications I should consider post-surgery?
  7. What are the long-term outcomes for patients who undergo pericardiectomy for constrictive pericarditis?
  8. Are there any alternative treatment options I should consider before deciding on pericardiectomy?
  9. How experienced is the surgical team in performing pericardiectomy procedures?
  10. Can you provide me with any additional resources or information about pericardiectomy and constrictive pericarditis?

Reference

Authors: Negishi K, Popović ZB, Negishi T, Motoki H, Alraies MC, Chirakarnjanakorn S, Dahiya A, Klein AL. Journal: J Am Soc Echocardiogr. 2015 Oct;28(10):1204-1213, e2. doi: 10.1016/j.echo.2015.05.011. Epub 2015 Jul 2. PMID: 26141982