Our Summary

This research paper discusses a rare case of a patient with constrictive pericarditis (a condition where the sac-like covering around the heart becomes too rigid) and multivessel coronary artery disease (a condition where several arteries that supply blood to the heart are blocked). The patient refused to undergo revascularization (a technique used to restore blood flow to the heart). Instead, the patient underwent a procedure called a pericardiectomy (removal of the rigid sac around the heart) with the help of a technique known as intra-aortic balloon pumping (a procedure that helps the heart pump more blood). The paper suggests that this approach is safe and effective, as long as the heart’s ability to pump blood (left ventricular ejection fraction) is normal. The researchers note that there is limited experience of pericardiectomy in patients with these combined conditions, especially those who refuse revascularization.

FAQs

  1. What is constrictive pericarditis and how is it related to pericardiectomy?
  2. What is meant by multivessel coronary artery disease and how it is managed if the patient refuses revascularization?
  3. How effective and safe is the pericardiectomy procedure with the help of intra-aortic balloon pumping in patients with combined conditions of constrictive pericarditis and multivessel coronary artery disease?

Doctor’s Tip

A doctor might tell a patient considering pericardiectomy the following helpful tip:

  • It is important to discuss all treatment options with your doctor, including the risks and benefits of pericardiectomy compared to other procedures such as revascularization. It is crucial to make an informed decision based on your individual health condition and preferences.

Suitable For

Pericardiectomy is typically recommended for patients with constrictive pericarditis, a condition where the sac-like covering around the heart becomes too rigid and limits the heart’s ability to expand and fill with blood properly. This can lead to symptoms such as shortness of breath, fatigue, and swelling in the legs and abdomen. Pericardiectomy is also recommended for patients with recurrent pericarditis, where the sac-like covering around the heart becomes inflamed and causes chest pain, fever, and other symptoms.

In some cases, pericardiectomy may be recommended for patients with constrictive pericarditis and multivessel coronary artery disease, especially if the patient is not a candidate for revascularization or if revascularization is not successful. Pericardiectomy can help improve symptoms and quality of life in these patients by relieving the constriction around the heart and allowing it to function more effectively.

Overall, pericardiectomy is typically recommended for patients with severe symptoms of constrictive pericarditis or recurrent pericarditis that have not responded to other treatments, and in some cases, for patients with constrictive pericarditis and coexisting coronary artery disease. It is important for patients to discuss their individual situation with their healthcare provider to determine if pericardiectomy is the right treatment option for them.

Timeline

Before pericardiectomy:

  • Patient presents with symptoms of constrictive pericarditis and multivessel coronary artery disease
  • Patient undergoes diagnostic tests such as echocardiogram, cardiac catheterization, and coronary angiography
  • Treatment options, including revascularization and pericardiectomy, are discussed with the patient
  • Patient elects to undergo pericardiectomy due to refusal of revascularization

After pericardiectomy:

  • Pericardiectomy procedure is performed, with the use of intra-aortic balloon pumping to assist with blood flow
  • Patient is monitored in the hospital for complications and recovery
  • Patient undergoes rehabilitation and physical therapy to regain strength and function
  • Follow-up appointments are scheduled to monitor the patient’s progress and overall cardiac health

Overall, the patient’s symptoms of constrictive pericarditis and multivessel coronary artery disease are successfully managed with the pericardiectomy procedure, leading to improved quality of life and cardiac function.

What to Ask Your Doctor

  1. What is a pericardiectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with a pericardiectomy?
  3. How long is the recovery process expected to be after a pericardiectomy?
  4. Will I need to undergo any additional treatments or therapies after the pericardiectomy?
  5. How will the pericardiectomy impact my overall heart health and function?
  6. Are there any lifestyle changes I should make to support my recovery after the pericardiectomy?
  7. What is the long-term outlook for someone who has undergone a pericardiectomy with multivessel coronary artery disease?
  8. Are there any alternative treatment options I should consider before proceeding with a pericardiectomy?
  9. How experienced is the medical team in performing pericardiectomies for patients with similar conditions to mine?
  10. Are there any specific follow-up appointments or tests I should schedule after the pericardiectomy to monitor my recovery and heart health?

Reference

Authors: Mo A, Yang X. Journal: Int J Surg Case Rep. 2018;49:231-234. doi: 10.1016/j.ijscr.2018.06.034. Epub 2018 Jul 9. PMID: 30048912