Author + information
- Received November 24, 2010
- Accepted December 9, 2010
- Published online August 2, 2011.
A 47-year-old male physician sought treatment for exertional dyspnea. History was remarkable for self-limiting parvovirus polyarthropathy. There was no history of radiation exposure. Physical examination was noncontributory and laboratory results were notable for past exposure to parvovirus. Chest computed tomography demonstrated a small pericardial effusion and pleural effusion. Transthoracic echocardiogram (A, Online Video 1) revealed left ventricular (LV) systolic dysfunction, ventricular interdependence, and a small organized pericardial effusion (arrow). Cardiac magnetic resonance imaging (B, Online Video 2) reconfirmed transthoracic echocardiogram findings and highlighted ventricular interdependence with septal shift (arrow). The patient underwent pericardiectomy (C), at which point he was noted to have a predominately epicardial tethering (arrow) consistent with constrictive epicarditis. His exercise capacity improved significantly after pericardiectomy, and so did his LV systolic function, as demonstrated by pre- and post-pericardiectomy longitudinal myocardial strain obtained by 2-dimensional speckle tracking (D) with global average peak systolic strain improving from −9.0% to −13.0%. RV = right ventricle.
- Received November 24, 2010.
- Accepted December 9, 2010.
- American College of Cardiology Foundation