Our Summary

This research paper is a review of the findings from using echo-Doppler (a type of ultrasound technology) in cases of effusive-constrictive pericarditis (ECP), which is a heart condition where there’s a significant fluid buildup around the heart and the outer layer of the heart is very stiff. This condition is diagnosed when symptoms of two other heart conditions, cardiac tamponade (pressure on the heart due to fluid buildup) and constrictive pericarditis (inflammation and stiffness of the outer layer of the heart), are present after a procedure (pericardiocentesis) to remove excess fluid from around the heart.

The paper notes that about 15% of patients with ECP showed these symptoms both before and after pericardiocentesis. The commonness of ECP after the fluid-removal procedure suggests that the condition might not be as severe as previously thought. However, more studies are needed to fully understand the condition’s effects on heart function. The paper also suggests that using echo-Doppler to evaluate patients before and after pericardiocentesis might help predict the condition’s progression and guide treatment decisions, but more research is needed to confirm this.

FAQs

  1. What is effusive-constrictive pericarditis (ECP) and how is it diagnosed?
  2. What are the recent findings on the prevalence of ECP based on echocardiography?
  3. Can the pre- and post-pericardiocentesis echo-Doppler findings be used to guide therapy of those undergoing pericardiocentesis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pericardiectomy is to ensure they follow up with regular echocardiograms to monitor for any signs of effusive-constrictive pericarditis (ECP) post-surgery. It is important to continue monitoring the heart’s function and hemodynamics to ensure optimal recovery and to catch any complications early on.

Suitable For

Patients who are typically recommended pericardiectomy are those with effusive-constrictive pericarditis (ECP) who have a hemodynamically significant pericardial effusion and markedly reduced compliance of the pericardium, as evidenced by constrictive physiology post-pericardiocentesis. ECP is diagnosed based on echocardiography findings and may present with features of both cardiac tamponade and constrictive pericarditis. Further studies are needed to better understand the underlying hemodynamics of ECP and to determine if echocardiography findings can be used to guide therapy for these patients.

Timeline

Before pericardiectomy, a patient may experience symptoms such as chest pain, shortness of breath, cough, fatigue, and swelling in the legs and abdomen. They may undergo diagnostic tests such as echocardiography and cardiac catheterization to confirm the diagnosis of effusive-constrictive pericarditis (ECP). Post-pericardiocentesis, the patient may still exhibit symptoms due to the constrictive physiology of the pericardium, which can mimic features of both cardiac tamponade and constrictive pericarditis on echo-Doppler findings. Further studies are needed to better understand the hemodynamics of ECP and determine if echo-Doppler findings can be used to guide therapy and prognosticate outcomes in patients undergoing pericardiocentesis. Pericardiectomy may be considered as a treatment option for patients with persistent symptoms and hemodynamically significant pericardial effusion.

What to Ask Your Doctor

  1. What is a pericardiectomy and why is it recommended for my condition?
  2. What are the potential risks and complications associated with a pericardiectomy?
  3. How long is the recovery process after a pericardiectomy?
  4. Will I need any additional treatments or medications after the surgery?
  5. How will a pericardiectomy improve my symptoms and quality of life?
  6. Are there any alternative treatment options to consider before proceeding with a pericardiectomy?
  7. What is the success rate of pericardiectomy for patients with my specific condition?
  8. How often will I need follow-up appointments and monitoring after the surgery?
  9. Can you explain the expected outcomes and potential long-term effects of a pericardiectomy?
  10. Are there any lifestyle changes or modifications I should make to support my recovery after a pericardiectomy?

Reference

Authors: Miranda WR, Newman DB, Oh JK. Journal: Curr Cardiol Rep. 2019 Nov 22;21(11):144. doi: 10.1007/s11886-019-1243-4. PMID: 31758271