Variability Toimimi DAKI in the Clinical Manifestations of Constrictive Pericarditis

Abstract

Summary: The variability in the clinical manifestations of constrictive pericarditis is described with the aid of 5 case illustrations. The first case, a boy who progressed from acute staphylococcal pericarditis to constrictive pericarditis within the space of 3 months, illus trates the difficulties in distinguishing between infective myocarditis and acute pericardial constriction. The second case simulated mitral stenosis while the third manifested physical and radiological signs that were sugges tive of subvalvar left ventricular aneurysm. The fourth case mimicked right ventricular endomyocardial fibrosis in terms of clinical, radiologic and an giocardiologic features, and the correct diagnosis was made only at autopsy. The fifth patient presented with massive ascites and hepatomegaly, and was initially suspected to have liver cirrhosis. Owing partly to the variability in its manifestations, there is often a delay in the diagnosis of constrictive pericarditis; and in the present series, the time lapse between onset of ill ness and diagnosis, ranged from 3 months to 8 years. We have therefore, suggested clues to the early recognition of the disease.