Constrictive pericarditis due to acute rheumatic fever

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Abstract
Nowadays constrictive pericarditis and acute rheumatic fever are rare conditions in childhood. We report the case of a girl aged 9 years who suffered from arthritis, erythema nodosum and pericarditis. The laboratory data indicated a streptococcal infection. Clinically the child had increasing symptoms of inflow obstruction of the heart. During cardiac catheterization, the pressures showed the typical pattern of constrictive pericarditis with elevated and nearly equal end-diastolic pressures in the right atrium and both ventricles. The echocardiogram showed a thickened pericardium with a small effusion and impaired function of the left ventricle. Because of clinical deterioration pericardiectomy was performed. During the first 3 days postoperatively the child was critically ill, with signs of global heart failure which improved only with adrenergic drugs plus nitrates. Now, 2.5 years after the operation, the child is in good health with only mild changes in the electrocardiogram and a normal ejection fraction of the left ventricle.

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