A correct diagnosis of constrictive, pericarditis is of paramount importance, since the disease can be treated surgically. Although th diagnosis could be made easily by clinical symptoms and physical findings, occassionally the clinical differenr relation between constrictive pericarditis and other emulating conditions may be difficult. The characteristic electrocardiographic findings often dre helpful in confirming the presence of constrictive pericarditis, however it remains nonspecific. Demonstration of characteristic pressure patterns by cardiac cathete rization prove an important diagnostic adjunct.
This paper reports hemodyna is studies and electrocardiographic findings in 7 patient with constrictive pericarditis who underwent cardiac catheterization at the Severance Hospital during the11 year period between 1964 anc 1975. Right heart catheterization was performed can 16- patients and 11 patients were subjected to right and left heart catheterization, and the findings were compatible with constrictive pericarditis.
Of the 27 patients, 15 were male and 12 were female. The ages ranged from 4 years to 60 years; the mean age was 32. 2 years.
1. The right atrial mean pressure (Mean±S.E.:17.4±1. 0 mmHg), the right ventricular and diastolic pressure (18.4±1.4 mmHg), the pulmonary diastolic pressure (19.4±0.8 mmHg ), and the pulmonary artery wedge mean pressure (18. ±1.4 mmHg) were markedly elevated and tended to be equal in all comparable cases. The right and left ventricular ealry diastolic pressures were above zero in all cases.
2. In all 11 cases which underwent left and right heart catheterization, the left ventricular end-diastolic pressure(22. 2±3.1 mmHg)was significantly elevated and slightly higher than the right ventricular end-diastolic pressure.
3. The right ventricular systolic pressure (36.8 ±2. 1 mmHg) was slightly elevated, but the left ventricular systolic pressure was normal(110.6±3.4mmHg).
4. The ratio between the right ventricular end-diastolic pressure and the right ventricular systolic pressure was obove one-third in all cases.
5. Although the pulmonary artery systolic pressure(36.5±2.0 mmHg) was elevated, the pulmonary artery resistance was normal(124.3±12.4 dynes.sec/cm5)
6. The cardiac index was lower than normal (2.47±0.39 L/min./m2 BSA).
7. In all 27 cases the electrocardiogram showed abnormal tracing. Nonspecific T wave changes were seen in 25 cases (92.6 percent). Among 20 cases showing regular sinus rhythm, 11 had P-mitrale and 2 P-pulmonary. Atrial fibrillation was identified in 7 cases (25.9 percent), and in one of them atrial flutter appeared transiently. The electical axis of QRS complex in frontal plane was normal in 25 cases (92.6 percent). Definite right axis deviation (more than 110 degree)was seen in 2 cases. True low voltage (QRS less than 5 mm in all limb tracings) occurred in 14 cases (51.9 percent).
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