Our Summary

This paper discusses the case of a 40-year-old woman who had suffered multiple instances of pericarditis, which is inflammation of the pericardium, the thin sac-like membrane surrounding the heart. Despite being treated with the best possible anti-inflammatory and biological treatments, her symptoms kept returning. The recommended treatment for such cases is a surgery known as a pericardiectomy, where the pericardium is removed. The woman underwent this surgery, but her symptoms still continued to come back. This case is considered to be of intermediate difficulty. The study involved the use of various methods and techniques such as cardiac magnetic resonance imaging (CMR), which is a type of medical imaging to visualize the heart and its structure.

FAQs

  1. What is pericardiectomy and when is it recommended for treatment?
  2. What is the case study of a 40-year-old woman who underwent total pericardiectomy?
  3. What happens when symptoms continue even after a pericardiectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pericardiectomy is to follow a post-operative care plan carefully, including taking prescribed medications as directed, attending follow-up appointments, and avoiding strenuous activities until cleared by the medical team. It is important to communicate any new or worsening symptoms to your healthcare provider to ensure a successful recovery.

Suitable For

Patients who are typically recommended pericardiectomy are those with recurrent pericarditis and refractory symptoms despite optimal anti-inflammatory therapy. These patients may have had multiple episodes of pericarditis that do not respond to standard treatments, such as anti-inflammatory and biologic agents. Pericardiectomy may be considered as a last resort for these patients to improve their symptoms and quality of life.

Timeline

Before pericardiectomy:

  • Patient experiences multiple episodes of pericarditis
  • Symptoms are refractory to optimal anti-inflammatory therapy
  • Patient may undergo various treatments, including anti-inflammatory and biologic agents
  • Patient continues to have relapsing symptoms despite medical therapy

After pericardiectomy:

  • Patient undergoes total pericardiectomy surgery
  • Recovery period post-surgery
  • Patient may still experience relapsing symptoms even after pericardiectomy
  • Further treatment and management may be required to address ongoing symptoms

What to Ask Your Doctor

  1. What is the purpose of a pericardiectomy?
  2. Am I a candidate for pericardiectomy?
  3. What are the risks and potential complications of pericardiectomy?
  4. What is the success rate of pericardiectomy in treating recurrent pericarditis?
  5. How long is the recovery period after pericardiectomy?
  6. Will I need to take any medications or undergo any follow-up procedures after the surgery?
  7. Are there any lifestyle changes I should make after a pericardiectomy?
  8. What symptoms should I watch out for after the surgery that may indicate a complication?
  9. How soon can I expect to see an improvement in my symptoms after the surgery?
  10. Are there any alternative treatments to pericardiectomy that I should consider before proceeding with the surgery?

Reference

Authors: Lak HM, Anthony CM, Furqan MM, Verma BR, Gad M, Chawla S, Yasmin F, Kwon DH, Johnston DR, Klein AL. Journal: JACC Case Rep. 2021 Dec 1;3(17):1877-1882. doi: 10.1016/j.jaccas.2021.10.006. eCollection 2021 Dec 1. PMID: 34917971