Multimodality imaging of pericardial disease

Current Cardiology Reports
Paul C Cremer, Deborah H Kwon

Abstract

The emergence of multimodality imaging of pericardial diseases has improved diagnosis and management. In acute pericarditis, echocardiography is the first-line test, but cardiac magnetic resonance (CMR) may be beneficial in patients who fail to respond to therapy. An increased T2 short-tau inversion recovery time (STIR) suggests pericardial edema, and increased late gadolinium enhancement (LGE) suggests organizing pericarditis. Computed tomography (CT) can be helpful in procedural planning, either to guide percutaneous drainage of an effusion or to assess calcification and the location of vascular structures before pericardiectomy. On echocardiography, a respiratory septal shift in combination with either a preserved medial e' velocity or prominent expiratory diastolic hepatic vein flow reversal performs well in diagnosing constrictive pericarditis. These patients also have decreased regional longitudinal strain in the anterolateral and right ventricular free walls, presumably related to pericardial to myocardial tethering. Finally, prominent LGE may identify patients with constrictive pericarditis who improve with anti-inflammatory therapy.

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Citations

Dec 23, 2015·Expert Review of Cardiovascular Therapy·Syed Wamique YusufPatrick T O'Gara
Aug 12, 2015·Nature Reviews. Cardiology·Massimo ImazioFiorenzo Gaita
Nov 29, 2016·Hospital Practice·Dario CelentaniFiorenzo Gaita
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Jan 8, 2017·Progress in Cardiovascular Diseases·Sneha VakamudiPaul C Cremer
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Jul 26, 2017·Archivos de cardiología de México·Zaira Yadira García-LópezLuis Efrén Santos-Martínez
Jan 11, 2020·Journal of the American College of Cardiology·Juan Guido ChiabrandoAntonio Abbate
Feb 24, 2021·Panminerva Medica·Michael ChetritAllan L Klein

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