Murat KERKÜTLÜOĞLU, Enes ÇELİK, Bayram ÖZTÜRK, Hakan GÜNEŞ

Karaciğer Sirozu Tanısı ile Takip Edilen Konstriktif Perikardit Olgusu

Özet Konstriktif perikardit (KP), elastik olmayan perikardın, kalp dolumunu engellemesi nedeniyle ortaya çıkan bir diyastolik kalp yetmezliği şeklidir. KP, açıklanamayan kalp yetmezliğinin ayırıcı tanısında, özellikle korunmuş sol ventrikül ejeksiyon fraksiyonlu kalp yetmezliği hastalarında düşünülmelidir. KP gelişimi için risk faktörleri; önceden kalp ameliyatı ve radyasyon tedavisini içerir, ancak çoğu vaka halen idiyopatik olarak kabul edilmektedir. Teşhisi zor olabilir ve sıklıkla kardiyak görüntüleme ve hemodinamik kateterizasyon ile desteklenen ekokardiyografik değerlendirme gerektirir. Komplet cerrahi perikardiyektomi, kronik KP için tek etkili tedavi yöntemidir. Genellikle kardiyak manyetik rezonans görüntüleme ile tanımlanan subakut enflamatuar KP’li hasta alt grubu, anti-enflamatuar tedavilere cevap verebilmektedir.

Anahtar Kelimeler:

Kalp yetmezliği, Konstriktif perikardit, Siroz

Constrictive Pericarditis Case with Liver Cirrhosis

Abstract Constrictive Pericarditis (CP) is a form of diastolic heart failure that occurs when non-elastic pericardium prevents heart filling. CP should be considered in the differential diagnosis of unexplained heart failure, especially in patients with heart failure with preserved ejection fraction. Although previous cardiac surgery and radiation therapy are the most frequently observed risk factors for CP development, most cases are still considered idiopathic. Diagnosis can be difficult and often requires echocardiographic evaluation supported by cardiac imaging and hemodynamic catheterization. Complete surgical pericardiectomy is the only effective treatment for chronic CP. A subacute subset of patients with subacute inflammatory CP, usually diagnosed by cardiac magnetic resonance imaging, is able to respond to anti-inflammatory treatments.

Keywords:

Cirrhosis, Constrictive pericarditis, Heart failure,

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