Figure 38e

Constrictive Pericarditis

With marked neck vein distention, swelling of the legs, and a knocking noise over the heart. Chest films showed extensive calcifications on the anterior and inferior surfaces of the heart involving both layers of pericardium. Magnetic resonance images (MRI), in panel A and panel B, show diffuse thickening of the entire pericardium, calcifications (arrows in Panel A), right atrial (RA) enlargement, a moderate amount of fluid between the two pericardial layers, and increased signal in the cavity, indicative of stasis of blood.
Panels C and D confirm the presence of pericardial fluid (arrow in Panel D) and showed atrial enlargement as well as an abnormal "shivering" motion of the interventricular septum. Pericardiectomy showed partially calcified tissue. RV denotes right ventricle, LV left ventricle, and LA left atrium.

Benedetti, E.D., Didier, D., Constrictive Pericarditis, The New England Journal of Medicine, July 13, 2000, p 107.

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