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European Journal of Echocardiography Advance Access originally published online on January 23, 2009
European Journal of Echocardiography 2009 10(2):344-346; doi:10.1093/ejechocard/jen331
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Massive pericarditis constrictiva calcarea with compression of the right ventricle and consecutive pulmonary embolism

Thomas Butz*, Hakan Yeni, Marc Van Bracht, Martin Christ, Gunnar Plehn, Sebastion Machnick, Axel Meissner and Hans-Joachim Trappe

Department of Cardiology and Angiology, Marienhospital Herne, Ruhr-University Bochum, Hölkeskampring 40, D-44625 Herne, Germany

Received 13 July 2008; accepted after revision 17 July 2008; online publish-ahead-of-print 23 January 2009.

* Corresponding author. Tel: +49 2323 4990; fax: +49 2323 499 360. E-mail address: thomas.butz{at}marienhospital-herne.de


  Abstract

A 40-year-old man was admitted with a massive pericarditis constrictiva calcarea. Transthoracic and transoesophageal echocardiography demonstrated a double-layered pericardial calcification with interspacial effusion, a massive compression of the right ventricle, and a thrombus formation in the ventricle. In addition, severe pulmonary embolism due to this right ventricular thrombus formation was diagnosed by CT. This case demonstrates the importance of a multimodal imaging approach (echocardiography, TDI, MRI, CT) in the diagnosis of constrictive pericarditis and pericardial masses. In respect to the severe pericardial calcification with the massive interspacial mass, and the compression of the right ventricle with thrombus formation and consecutive pulmonary embolism, this case appears to be a very rare and uncommon clinical finding.

Keywords: Constrictive pericarditis; Tissue doppler imaging; Magnetic resonance imaging; Pulmonary embolism


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