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European Journal of Echocardiography Advance Access published online on April 5, 2007
European Journal of Echocardiography, doi:10.1016/j.euje.2007.02.006
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Severe calcification of the lateral mitral annulus in constrictive pericarditis: a potential pitfall for the use of echocardiographic tissue Doppler imaging

Thomas Butz*, Christoph Langer, Werner Scholtz, Smita Jategaonkar, Nikola Bogunovic, Dieter Horstkotte and Lothar Faber

Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany

Received 16 October 2006; accepted after revision 14 February 2007.

* Corresponding author. Tel: +49 5731 971258; fax: +49 5731 972194. E-mail address: akohlstaedf{at}hdz-nrw.de


  Abstract

According to the guidelines of the European Society of Cardiology on the diagnosis and management of pericardial diseases, tissue Doppler imaging (TDI) is proposed to be part of the diagnostic work-up in patients with suspected constrictive pericarditis (CP). We describe a case which illustrates that TDI analysis may be misleading in patients with severe pericardial calcifications of the lateral mitral annulus. Multi-slice computed tomography (MSCT) data in this case contributed much to a better understanding of the impact of heterogeneous calcification patterns on the results of TDI assessment in CP.

Keywords: Constrictive pericarditis; Tissue Doppler echocardiography; Annular calcification; Multi-detector computed tomography; Mitral annulus; Restrictive cardiomyopathy


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