Our Summary

This research paper discusses a rare medical condition called calcific constrictive pericarditis, which is a complication that can occur in patients with systemic sclerosis. In this case, a 53-year-old woman with systemic sclerosis was diagnosed with this condition. She had a history of heart failure. To treat her, doctors performed a pericardiectomy, a surgery where the pericardium, the membrane enclosing the heart, is removed. The woman showed significant improvement three months after the surgery. This is the first recorded case of a patient with systemic sclerosis and calcific constrictive pericarditis being treated with a pericardiectomy.

FAQs

  1. What is calcific constrictive pericarditis and who does it affect?
  2. What is a pericardiectomy and how was it used to treat this patient’s condition?
  3. Has a pericardiectomy been previously used to treat patients with systemic sclerosis and calcific constrictive pericarditis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and gradually increasing physical activity as advised by your healthcare provider. It is also important to report any unusual symptoms or concerns to your doctor promptly. Following these guidelines can help ensure a successful recovery and optimal outcome after pericardiectomy surgery.

Suitable For

Pericardiectomy is typically recommended for patients with constrictive pericarditis, a condition where the pericardium becomes thickened and rigid, restricting the heart’s ability to expand and fill with blood properly. This can lead to symptoms such as shortness of breath, chest pain, fatigue, and fluid retention.

Patients who may benefit from a pericardiectomy include those with:

  • Recurrent pericarditis that does not respond to conservative treatments such as medication
  • Constrictive pericarditis that is causing severe symptoms and complications such as heart failure
  • Calcific constrictive pericarditis, where calcium deposits form in the pericardium and contribute to its thickening and constriction

In some cases, patients with systemic diseases such as systemic sclerosis may develop complications like calcific constrictive pericarditis, requiring surgical intervention like a pericardiectomy. Patients with systemic sclerosis may be at higher risk for developing pericardial complications due to inflammation and fibrosis affecting multiple organs.

Overall, patients who are experiencing severe symptoms and complications due to constrictive pericarditis may be recommended for a pericardiectomy to improve their quality of life and reduce the risk of further complications. It is important for patients to discuss their individual case with their healthcare provider to determine the most appropriate treatment approach.

Timeline

Before Pericardiectomy:

  • Patient presents with symptoms of heart failure, such as shortness of breath, fatigue, and leg swelling
  • Diagnostic tests, such as echocardiogram and cardiac CT scan, reveal calcific constrictive pericarditis
  • Patient undergoes preoperative evaluation to assess surgical risk and determine the best treatment plan

Pericardiectomy Procedure:

  • Surgery is performed to remove the thickened and calcified pericardium that is constricting the heart
  • The surgery typically involves opening the chest cavity and carefully dissecting and removing the pericardium
  • The patient is closely monitored in the intensive care unit postoperatively to manage pain and prevent complications

After Pericardiectomy:

  • Patient undergoes a period of recovery in the hospital, which may involve physical therapy and monitoring for any complications
  • Follow-up appointments with the surgical team and cardiologist are scheduled to monitor the patient’s progress
  • Patient experiences improvement in symptoms, such as decreased shortness of breath and improved exercise tolerance
  • Long-term follow-up is necessary to monitor for any recurrence of symptoms or complications

Overall, pericardiectomy can be a life-saving procedure for patients with conditions like calcific constrictive pericarditis, leading to significant improvement in symptoms and quality of life.

What to Ask Your Doctor

  1. What is a pericardiectomy and why is it necessary for my condition?
  2. What are the potential risks and complications associated with a pericardiectomy?
  3. How long is the recovery time after a pericardiectomy and what can I expect during the recovery process?
  4. Will I need any additional treatments or medications following the surgery?
  5. How likely is it that my symptoms will improve after the pericardiectomy?
  6. Are there any lifestyle changes or restrictions I should be aware of after the surgery?
  7. How frequently will I need follow-up appointments to monitor my condition post-surgery?
  8. Are there any long-term implications or considerations I should be aware of after a pericardiectomy?
  9. Are there any alternative treatment options available for my condition?
  10. How experienced is the surgical team in performing pericardiectomies and what is the success rate for this procedure?

Reference

Authors: Totaro A, Sacra C, Testa G, Pierro A, Ienco V, Calvo E, Calabrese R, Castellano G, Lubrano E, Perrotta F, Scriffignano S, Calafiore AM. Journal: Curr Probl Cardiol. 2023 Sep;48(9):101796. doi: 10.1016/j.cpcardiol.2023.101796. Epub 2023 May 14. PMID: 37192678