CONSTRICTIVE PERICARDITIS CAUSED BY AN OLD HEMATOMA

A 46-year-old woman was admitted for surgery after diagnosis of a cons trictive pericarditis. She had suffered from acute pericarditis and un dergone pericardiocentesis to relieve pericardial effusion several tim es 10 years previously. Cardiac catheterization showed elevated mean r ight-atrial and pulmonary wedge pressures. Chest CT revealed only a ca lcified mass in the retrosternal space. At surgery, there was no sever e adhesion between the pericardium and the epicardium, and the pericar dium was thin and almost normal except over the right artio-ventricula r groove, where a hard mass with an atheromatous content adhered to th e epicardium. After resection of the mass, central venous pressure and pulmonary wedge pressure decreased. The mass was found to be an old h ematoma by pathological examination. The patient was subsequently disc harged from hospital in good condition.