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A Case of Massive General Edema due to Constrictive Pericarditis which was Hard to Diagnose Kazuhiro Osawa 1 , Kunihisa Kohno 1 , Masatoki Yoshida 1 , Hideyuki Suzuki 1 , Machiko Tanakaya 1 , Kazufumi Takeuchi 1 , Natsuki Takahashi 1 , Jun Iwasaki 1 , Yusuke Katayama 1 , Teruo Shiraki 1 , Daiji Saito 1 1Department of Cardiology, National Hospital Organization Iwakuni Clinical Center Keyword: 収縮性心膜炎 , 右心不全 , 全身浮腫 , constrictive pericarditis , right heart failure , general edema pp.433-437
Published Date 2009/4/15
DOI https://doi.org/10.11477/mf.1404101245
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 A 66-year-old man was admitted to our hospital due to massive general edema and shortness of breath. Several physicians he visited previously carried out examinations including catheterization, but failed to clarify the cause of the edema. After admission, collagen disease, renal disease, and some other possible disorders were excluded. Right heart failure was obvious on admission and was rapidly getting worse day by day. The patient's body weight increased from 80 kg to 94 kg in 30 days despite sufficient diuretics. Cardiac catheterization exhibited a dip and plateau pattern of the right ventricular pressure wave form and highly elevated right ventricular systolic pressure. This led to the diagnosis of constrictive pericarditis. Cardiolysis surgery was performed, followed by an excellent post-operative clinical course. His weight dropped from 94 kg to 60 kg at discharge which is his standard weight. This case suggests that in the case of unidentified right heart failure, constrictive pericarditis should be taken into consideration as a differential diagnosis.


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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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