Case of Carcinoma left breast (post operative and post radiotherapy) with features of heart failure
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There is diffuse thickening of the anterior pericardium, upto the vascular root, best seen in multiplanar reformat images. Indentation of right ventricle is seen, causing a "tubular" configuration.
Post-op changes are seen in left chest wall.
The IVC is dilated to more than double the aortic diameter
5 case questions available
Common causes of constrictive pericarditis include injury, infection, radiotherapy. Radiotherapy is most likely cause in this patient.
It should however, be accompanied by clinical signs of heart failure. Imaging signs that suggest heart failure (especially right heart) are: dilated RA, dilated hepatic veins, dilated IVC to more than twice aortic diameter, periportal edema, enlarged SVC > adjacent aorta, reflux of contrast into IVC and distal hepatic veins (proximal reflux can be seen with high flow rates).
- 1. Wang ZJ, Reddy GP, Gotway MB et-al. CT and MR imaging of pericardial disease. Radiographics. 2003;23 Spec No : S167-80. doi:10.1148/rg.23si035504 - Pubmed citation
- 2. Restrepo CS, Lemos DF, Lemos JA et-al. Imaging findings in cardiac tamponade with emphasis on CT. Radiographics. 27 (6): 1595-610. doi:10.1148/rg.276065002 - Pubmed citation