Author + information
- Christopher A. Miller, MBChB⁎ (, )
- Helen Dormand, MBBChir,
- David Clark, BSc,
- Mark Jones, MD,
- Paul Bishop, MBBCh and
- Matthias Schmitt, MD, PhD
- ↵⁎Address for correspondence:
Dr. Christopher Miller, North West Regional Cardiac Centre, University Hospital of South Manchester, Wythenshawe, Manchester M23 9LT, United Kingdom
constrictive pericarditis continues to be a diagnostic and therapeutic challenge. Even with invasive cardiac catheterization its distinction from restrictive cardiomyopathy, which shares features of impaired ventricular filling, can remain difficult.
Cardiac magnetic resonance (CMR) is uniquely placed to characterize constrictive pericarditis. CMR comprehensively defines pericardial and myocardial anatomy as well as their structural and functional relationship. Indeed, through evaluation of regional myocardial deformation, ventricular interaction and venous return, CMR can accurately assess the physiological consequences of pericardial constriction. Furthermore, CMR provides in vivo insight into pericardial histology. As such, the diagnosis of constrictive pericarditis has become possible using a single, noninvasive investigation.
The ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 Appropriateness Criteria for Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging (1) indicates that CMR is appropriate for evaluation of pericardial conditions, including pericardial constriction. More recently the ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (2) recommends that CMR may be used as a noninvasive imaging modality to diagnose patients with suspected pericardial disease. In this paper we present a case that demonstrates the value of multiparametric CMR in the noninvasive assessment of constrictive pericarditis and the subsequent recovery following surgical intervention (Figs. 1, 2, 3, 4, 5, and 6⇓⇓⇓).
For supplementary videos and their legends, please see the online version of this article.
Dr. Miller is supported by a Fellowship from the National Institute for Health Research (United Kingdom). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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