Details

Autor(en) / Beteiligte

• Neves, Precil Diego Miranda de Menezes
• Lario, Fábio Cerqueira
• Mohrbacher, Sara
• Ferreira, Bernadete Maria Coelho
• Sato, Victor Augusto Hamamoto
• Oliveira, Érico Souza
• Pereira, Leonardo Victor Barbosa
• Bales, Alessandra Martins
• Nardotto, Luciana Loureiro
• Ferreira, Jéssica Nogueira
• Cavalcante, Lívia Barreira
• Chocair, Pedro Renato
• Cuvello-Neto, Américo Lourenço

Titel

Dialysis-related constrictive pericarditis: old enemies may sometimes come back

Ist Teil von

• Brazilian Journal of Nephrology, 2022-10, Vol.44 (4), p.602-606

Ort / Verlag

Brazil: Sociedade Brasileira de Nefrologia

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Cardiovascular disease is the main cause of death in patients with chronic kidney disease (CKD). Several heart conditions have been associated with CKD, including myocardial and pericardial diseases. This paper describes a case of Dialysis-related constrictive pericarditis in a patient diagnosed with sudden hypotension during a hemodialysis session. A 65-year-old man diagnosed with hypertension, diabetes, obesity, and cirrhosis on hemodialysis for two years complained of symptoms during one of his sessions described as malaise, lipothymia, and confusion. The patient had a record of poor compliance with the prescribed diet and missed dialysis sessions. He was sluggish during the physical examination, and presented hypophonetic heart sounds, a blood pressure of 50/30mmHg, and a prolonged capillary refill time. The patient was referred to the intensive care unit and was started on antibiotics and vasoactive drugs. His workup did not show signs of infection, while electrocardiography showed low QRS-wave voltage. His echocardiogram showed signs consistent with a thickened pericardium without pericardial effusion. Cardiac catheterization showed equalization of diastolic pressures in all heart chambers indicative of constrictive pericarditis. The patient underwent a pericardiectomy. Examination of surgical specimens indicated he had marked fibrosis and areas of dystrophic calcification without evidence of infection, consistent with Dialysis-related constrictive pericarditis. Hypotension for unknown causes must be considered in the differential diagnosis of dialysis patients.