[Unilateral transudative pleural effusion and constritive pericarditis].

Autor:	Veil-Picard M; Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France. Electronic address: matthieuveil@gmail.com., Rival G; Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France; Service de réanimation, centre hospitalier de Montélimar, 26200 Montélimar, France., Aupècle B; Service de chirurgie thoracique, CHU de Besançon, 25000 Besançon, France., Laluc F; Service de chirurgie thoracique, CHU de Besançon, 25000 Besançon, France., Maitre J; Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France., Seronde MF; Service de cardiologie, CHU de Besançon, 25000 Besançon, France., Dalphin JC; Service de pneumologie, CHU de Besançon, 4, boulevard Fleming, 25000 Besançon, France.
Jazyk:	francouzština
Zdroj:	Revue des maladies respiratoires [Rev Mal Respir] 2015 Jan; Vol. 32 (1), pp. 58-65. Date of Electronic Publication: 2014 Aug 05.
DOI:	10.1016/j.rmr.2014.07.002
Abstrakt:	Introduction: Constrictive pericarditis is associated with thickening, fibrosis or inflammation of the pericardium which can lead to signs of right ventricle dysfunction. It is usually a chronic process which can present in a variety of ways. We present two cases of constrictive pericarditis discovered during the investigation of a left-sided pleural effusion. Observation: The cases represent two sorts of constrictive pericarditis, chronic and due to pericardial effusions. Their common feature was an increase in dyspnoea and a new pleural effusion on the left side. Their difference lies in the presence of a thickened calcified pericardium in one case and the presence of a pericardial effusion in the other. In both cases, non-invasive investigation failed to diagnose any cardiac disease. The presence of constrictive pericarditis was confirmed by right heart catheterization. Treatment by subtotal pericardectomy was effective. Conclusion: The thoracic manifestations of constrictive pericarditis are most commonly recurring bilateral pleural effusions. The mode of presentation may be an exudative, or transudative effusion. Unilateral pleural involvement, fibrosis, chylothorax or tumour like presentations may occur. A diagnosis of constrictive pericarditis should be considered in these clinical contexts and an examination of the pericardium performed. Cardiac catheterization can help in the differential diagnosis. (Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.)
Databáze:	MEDLINE
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