Our Summary

This research paper discusses the case of a 15-year-old girl who has a history of asthma and obesity. She repeatedly suffered from anasarca, a condition in which there is generalized swelling of the body. However, she didn’t have systolic heart failure or any significant kidney disease, which are common causes of anasarca.

After diagnosing her, it was found that she had constrictive pericarditis, a condition where the sac that surrounds the heart (pericardium) becomes hard and constricted, affecting the heart’s function.

To treat the condition, she successfully underwent a surgical procedure known as pericardiectomy, in which the pericardium is removed. Additionally, a “waffle procedure” was performed, which is a surgical technique used to deal with the remaining pericardium or to prevent constriction. The paper suggests that this was a complex case.

FAQs

  1. What is constrictive pericarditis and how is it diagnosed?
  2. What does a pericardiectomy procedure involve?
  3. What is a waffle procedure in the context of a pericardiectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pericardiectomy is to follow post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and gradually increasing activity levels as advised by their healthcare provider. It is also important for patients to maintain a healthy lifestyle to support the healing process and prevent complications.

Suitable For

Patients who are typically recommended for pericardiectomy are those with constrictive pericarditis, a condition where the pericardium becomes thickened and rigid, leading to impaired cardiac function. This condition can cause symptoms such as anasarca (severe swelling), shortness of breath, and fatigue. Patients who do not respond to medical management or have severe symptoms that significantly impact their quality of life may be candidates for pericardiectomy. It is important to note that pericardiectomy is a complex surgical procedure and should be performed by experienced cardiac surgeons in specialized centers.

Timeline

Before pericardiectomy:

  1. Patient presents with symptoms such as anasarca, shortness of breath, fatigue, and chest pain.
  2. Diagnostic tests such as echocardiogram, MRI, CT scan, and cardiac catheterization are performed to confirm constrictive pericarditis.
  3. Patient undergoes preoperative evaluation and preparation for surgery, including medications to manage symptoms and optimize cardiac function.

After pericardiectomy:

  1. Patient undergoes pericardiectomy surgery with pericardial stripping and possibly additional procedures such as a waffle procedure.
  2. Postoperative care includes monitoring in the intensive care unit, pain management, and prevention of complications such as infection and bleeding.
  3. Patient undergoes cardiac rehabilitation and physical therapy to regain strength and mobility.
  4. Follow-up appointments with the healthcare team are scheduled to monitor recovery, manage any residual symptoms, and assess long-term outcomes.

What to Ask Your Doctor

  1. What is constrictive pericarditis and how does it affect my health?
  2. What are the potential risks and complications associated with pericardiectomy?
  3. How long is the recovery process after undergoing a pericardiectomy?
  4. Will I need any additional medications or treatments following the surgery?
  5. What lifestyle changes should I make after the surgery to prevent future complications?
  6. How often will I need follow-up appointments to monitor my condition?
  7. Are there any restrictions on physical activity or diet that I should be aware of post-surgery?
  8. What are the chances of the condition recurring after the pericardiectomy?
  9. Are there any alternative treatment options for constrictive pericarditis that I should consider?
  10. How will the surgery improve my symptoms and overall quality of life?

Reference

Authors: Moss R, Ali AM, Mahgerefteh J, Panesar LE, Pastuszko P, Murthy R, Kaushik S. Journal: JACC Case Rep. 2023 Oct 4;23:102009. doi: 10.1016/j.jaccas.2023.102009. eCollection 2023 Oct 4. PMID: 37954955