Vol. 43 | No. 1 | January-June 2015 Back

Open Access

Chronic Constrictive Pericarditis: The Experience in the Philippine Heart Center and the Philippine General Hospital

Raul D. Jara, Thessie Minelli O. Valdez, Jesse Jane R. Roque
Jun 2015 DOI 10.69944/pjc.6026bca75b

Abstract

BACKGROUND: Chronic constrictive pericarditis (CCP) in developing countries is usually due to tuberculous  pericarditis. This study aims to determine the patient profile, clinical presentations, different  diagnostic tests, procedures and outcomes of CCP at the Philippine Heart Center (PHC) and the  Philippine General Hospital (PGH). 

METHODOLOGY: This was a retrospective study that included all adult patients who were admitted to PHC and PGH  for tuberculous pericarditis between January 2010 and December 2013. Characteristics, clinical  course and outcomes of patients were described.  

RESULTS: The study included 67 patients from PHC and 22 patients from PGH, with a mean age of 38  years. The male-to-female ratios were 2.19:1 for PHC and 3.41:1 for PGH. Dyspnea was the most  common complaint, present in 93% of PHC patients and 59% from PGH. Cardiac tamponade  was documented by echocardiography in 36% of PHC patients and 46% from PGH. Anti-Koch’s  therapy was given to 100% at PHC and 64% at PGH. Pericardiectomy was done on 12% of patients  from PHC and 55% at PGH. Perioperative mortality was 3% for PHC and 5% for PGH. 

CONCLUSION: CCP is common in tuberculous pericarditis. PHC and PGH varied in their CCP management.  Pericardiectomy may improve the outcome of patients with CCP. 

KEYWORDS: chronic constrictive pericarditis, tuberculous pericarditis.

References
  1. Khandaker MH, Espinosa RE, Nishimura RA, Sinak LJ, Hayes  SN, Melduni RM, Oh JK. Pericardial disease: diagnosis and  management. Mayo Clin Proc. 2010;85(6):572-93. 
  2. Ling LH, Oh JK, Schaff HV, Danielson GK, Mahoney DW, Seward  JB, Tajik AJ. Constrictive pericarditis in the modern era: evolving  clinical spectrum and impact on outcome after pericardiectomy.  Circulation. 1999;100(13):1380-6. 
  3. Schwefer M, Aschenbach R, Heidemann J, Mey C, Lapp H.  Constrictive pericarditis, still a diagnostic challenge: comprehensive  review of clinical management. Eur J Cardiothorac Surg. 2009;36(3):502-10.
  4. Marshall A, Ring N, Lewis T. Constrictive pericarditis: lessons from  the past five years’ experience in the South West Cardiothoracic  Centre. Clin Med. 2006;6(6):592-7. 
  5. Mehta A, Mehta M, Jain AC. Constrictive pericarditis. Clin Cardiol.  1999;22(5):334-44. 
  6. McCaughan BC, Shaff HV, Piehler JM, Danielson GK, Orzurlak  TA, Puga FJ, Pluth JR, Connolly DC, McGoon DC. Early and  late results of pericardiectomy for constrictive pericarditis. J Thorac  Cardiovasc Surg. 1985;89(3):340-50. 
  7. Tirilomis T, Unverdorben S, von der Emde J. Pericardectomy  for chronic constrictive pericarditis: risk and outcome. Eur J  Cardiothorac Surg. 1994;8(9):487-92. 
  8. Mayosi BM, Ntsekhe M, Volmink JA, Commerford PJ. Interventions  for treating tuberculous pericarditis. Cochrane Database Syst Rev.  2002;(4):CD000526. 
  9. Chen RF, Lai CP. Clinical characteristics and treatment of  constrictive pericarditis in Taiwan. Circ J. 2005 Apr;69(4):458-460. 
  10. Yang HS, Song JK, Kang DH, Lee CW, Nam GB, Choi KJ,  Kim YH, Hong MK, Kim JJ, Park SW, Park SJ, Song H, Lee  JW, Song MG. Clinical characteristics of constrictive pericarditis  diagnosed by echo-Doppler technique in Korea. J Korean Med Sci.  2001;16(5):558-66. 
  11. Sagrista-Sauleda J, Permanyer-Miralda G, Soler-Soler J. Tuberculous  pericarditis : ten year experience with a prospective protocol for  diagnosis and treatment. J Am Coll Cardiol. 1988;11(4):724-8. 
  12. Banerjee S, Swanton RH. Pericardial constriction: diagnosis and  management. Hosp Med. 2002;63(2):72-9. 
  13. Sagrista-Sauleda J, Angel J, Sanchez A, Permanyer-Miralda G,  Soler-Soler J. Effusive-constrictive pericarditis. N Engl J Med.  2004;350(5):469-75.
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