Calcific Constrictive Pericarditis FREE

Calcium deposits in the sac around the heart (pericardium) can sometimes be seen on x-rays. When these calcium deposits occur in patients with heart failure, they suggest a condition known as constrictive pericarditis. In this condition, stiff scar tissue in the pericardium squeezes the heart and prevents it from beating normally. Tuberculosis used to be a common cause of constrictive pericarditis; now, as tuberculosis has become less frequent in the United States, more common causes are previous heart operation, pericarditis, and radiation treatment.

They wanted to learn the significance of calcium deposits in the pericardium in patients with constrictive pericarditis during recent years, a time when tuberculosis has been relatively uncommon.

One hundred thirty-five patients seen at the Mayo Clinic between 1985 and 1995 who definitely had constrictive pericarditis.

The researchers examined patients' chest x-rays to see how many had visible calcium deposits. They then compared how well patients did according to whether calcium was or was not seen in the pericardium.

Calcium deposits were seen in the pericardium in 36 of the 135 patients. The patients with calcium deposits more often had an unknown cause of constrictive pericarditis than those without the deposits. Patients with calcium deposits were also more likely to have been sick a long time, to have other signs of pericarditis on physical examination, and to die during surgery performed to remove the diseased pericardium. However, in patients who survived surgery, those with calcium deposits lived as long as those without them over the long term.

All of the patients were studied at a single institution; it is unclear whether the results would be the same for patients in other geographic areas. Also, it is possible that newer and more accurate ways of examining the pericardium, such as CT scan, may predict more accurately which patients with constrictive pericarditis will do poorly.

Although tuberculosis is now uncommon, calcium deposits in the pericardium are still often found on x-rays of patients with constrictive pericarditis. The presence of these deposits may indicate that patients have had the condition longer and may possibly be a sign that they are more likely to die during surgery to remove the diseased pericardium.