Background
Constrictive pericarditis is a disease characterized by inflammation,
fibrosis and loss of elasticity of the pericardium, leading to
restricted ventricular filling and diastolic dysfunction. Consequently,
there is an increase in ventricular interdependence and dissociation of
intracardiac and intrathoracic pressures during ventilation. Clinically,
insidious signs and symptoms of venous congestion, predominantly
systemic, appear. It is a relatively rare condition, with varied causes
[1,2]. Tuberculous pericarditis is an uncommon cause of pericarditis
in developed countries but may account for up to 30% of pericarditis
cases in endemic countries [3]. Progression to constrictive
pericarditis is reported in up to 30% of cases of tuberculous
pericarditis [4]. Pericardiectomy is the standard treatment for
patients with symptomatic constrictive pericarditis [5]. However, an
intrinsic risk to surgery is right ventricle (RV) dysfunction, a
consequence of myocardial atrophy [6] and the abrupt increase in
venous return that lead to volume overload, mainly in the RV.
Echocardiography is an effective method to monitor these
post-pericardiectomy hemodynamic changes.
We report the case of a 41-year-old male patient who developed new RV
dysfunction two weeks after pericardiectomy for tuberculous constrictive
pericarditis.