Abnormal Neck Veins

Park, Sun-Hee; Eleid, Mackram F.; Michelena, Héctor I.

doi:10.1001/jamacardio.2016.0540

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…This phenomenon (Kussmaul's sign) is opposite to normal condition when, during inspiration, usually JVP falls because more blood enters into RV. Moreover, JVP increase is associated to peculiar invasive pressure patterns (sharp descending "y" wave associated to rapid ventricle diastolic inflow and, if sinus rhythm is present, sharp descending "x" wave associated with late systolic inflow produced by atrial contraction) [7]. Consequently, the presence of peripheral edema, hepatomegaly, and, eventually, ascites are the cornerstone of clinical assessment.…”

Section: Clinical "Red Flags"mentioning

confidence: 99%

Constrictive Pericarditis

Lauri¹

2023

Pericarditis - Diagnosis and Management Challenges

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Constrictive pericarditis (CP) is a challenging clinical scenario in which the heart muscle is entrapped by thick, fibrous, and frequently calcified pericardial layers. Whereas infectious diseases (mostly bacterial) had been observed as the main etiology in the last decades, nowadays, post-surgical or radiotherapy iatrogenic inflammation is becoming highly prevalent with the exception of developing countries and patients with immunodeficiency in which tuberculosis is still frequently observed. Clinically, progressive dyspnea and peripheral edema are present and frequently considered of unknown origin because of the diagnostic challenge that CP poses. As a matter of fact, a specific knowledge of echocardiography and right heart catheterization is essential to recognize constriction features. Moreover, a valuable support is provided by dedicated imaging modalities (mostly magnetic resonance). Complete surgical removal of the pericardium (pericardiectomy), when feasible and performed early, is associated with excellent symptomatic improvement. Unfortunately, in specific scenarios (radiation therapy) or when surgery is performed after severe constriction development, surgical outcomes are poor, and CP assumes the profile of an end-stage disease. This reinforces the unmet need of early detection of CP and the development of novel therapeutic strategies.

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Section: Clinical "Red Flags"mentioning

confidence: 99%

Constrictive Pericarditis

Lauri¹

2023

Pericarditis - Diagnosis and Management Challenges

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Differentiation of Constriction and Restriction

Geske

Anavekar

Nishimura

et al. 2016

Journal of the American College of Cardiology

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Differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) is a complex and often challenging process. Because CP is a potentially curable cause of heart failure and therapeutic options for RCM are limited, distinction of these 2 conditions is critical. Although different in regard to etiology, prognosis, and treatment, CP and RCM share a common clinical presentation of predominantly right-sided heart failure, in the absence of significant left ventricular systolic dysfunction or valve disease, due to impaired ventricular diastolic filling. Fundamental to the diagnosis of either condition is a clear understanding of the underlying hemodynamic principles and pathophysiology. We present a contemporary review of the pathophysiology, hemodynamics, diagnostic assessment, and therapeutic approach to patients presenting with CP and RCM.

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