Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients

Although well documented, constrictive pericarditis is a rare entity and an uncommon cause of heart failure. A stiff and noncompliant pericardium creates the disease’s unique hemodynamics and leads to elevated venous pressures, hepatic sinusoidal congestion, and draining of protein-rich fluid into t...

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Main Authors: Sarah Barbina MD, Umakanthan Kavin MD, Michael M. Sutton DO, Marc Heincelman MD, MPH, Meghan K. Thomas MD, MS
Format: Article
Language:English
Published: SAGE Publishing 2022-05-01
Series:Journal of Investigative Medicine High Impact Case Reports
Online Access:https://doi.org/10.1177/23247096221097530
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author Sarah Barbina MD
Umakanthan Kavin MD
Michael M. Sutton DO
Marc Heincelman MD, MPH
Meghan K. Thomas MD, MS
author_facet Sarah Barbina MD
Umakanthan Kavin MD
Michael M. Sutton DO
Marc Heincelman MD, MPH
Meghan K. Thomas MD, MS
author_sort Sarah Barbina MD
collection DOAJ
description Although well documented, constrictive pericarditis is a rare entity and an uncommon cause of heart failure. A stiff and noncompliant pericardium creates the disease’s unique hemodynamics and leads to elevated venous pressures, hepatic sinusoidal congestion, and draining of protein-rich fluid into the peritoneal cavity presenting as ascites. The low incidence in addition to its varied and subtle clinical presentations can often lead to a delay in diagnosis. Here, we present 2 clinical cases of constrictive pericarditis in which ascitic fluid analysis was important—one patient who presented with new-onset ascites with concern for cirrhosis and another patient who presented with symptoms concerning for heart failure with ascites. Through their hospital course and workup, we highlight the importance of diagnostic sampling of ascitic fluid to prompt the consideration of constrictive pericarditis followed by utilizing advanced diagnostics, such as echocardiogram and cardiac catheterization to reach the correct diagnosis in an otherwise often overlooked pathology.
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spelling doaj.art-028405856dab4fdfa378efca34f204d32022-12-22T02:11:21ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962022-05-011010.1177/23247096221097530Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 PatientsSarah Barbina MD0Umakanthan Kavin MD1Michael M. Sutton DO2Marc Heincelman MD, MPH3Meghan K. Thomas MD, MS4Department of Medicine, Medical University of South Carolina, Charleston, USADepartment of Medicine, Medical University of South Carolina, Charleston, USADepartment of Medicine, Medical University of South Carolina, Charleston, USADepartment of Medicine, Medical University of South Carolina, Charleston, USADepartment of Medicine, Medical University of South Carolina, Charleston, USAAlthough well documented, constrictive pericarditis is a rare entity and an uncommon cause of heart failure. A stiff and noncompliant pericardium creates the disease’s unique hemodynamics and leads to elevated venous pressures, hepatic sinusoidal congestion, and draining of protein-rich fluid into the peritoneal cavity presenting as ascites. The low incidence in addition to its varied and subtle clinical presentations can often lead to a delay in diagnosis. Here, we present 2 clinical cases of constrictive pericarditis in which ascitic fluid analysis was important—one patient who presented with new-onset ascites with concern for cirrhosis and another patient who presented with symptoms concerning for heart failure with ascites. Through their hospital course and workup, we highlight the importance of diagnostic sampling of ascitic fluid to prompt the consideration of constrictive pericarditis followed by utilizing advanced diagnostics, such as echocardiogram and cardiac catheterization to reach the correct diagnosis in an otherwise often overlooked pathology.https://doi.org/10.1177/23247096221097530
spellingShingle Sarah Barbina MD
Umakanthan Kavin MD
Michael M. Sutton DO
Marc Heincelman MD, MPH
Meghan K. Thomas MD, MS
Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients
Journal of Investigative Medicine High Impact Case Reports
title Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients
title_full Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients
title_fullStr Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients
title_full_unstemmed Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients
title_short Ascitic Fluid Analysis Leading to the Diagnosis of Constrictive Pericarditis in 2 Patients
title_sort ascitic fluid analysis leading to the diagnosis of constrictive pericarditis in 2 patients
url https://doi.org/10.1177/23247096221097530
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