ANGIOCARDIOGRAPHY IN DIAGNOSIS OF EFFUSIVE-RESTRICTIVE PERICARDITIS

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Abstract
Angiocardiography is a reliable method for diagnosis of pericardial effusion and also provides significant data regarding the cardiovascular structures. In frontal view, it shows the classic soft-tissue density of pericardial fluid surrounding the heart; in lateral view, there is retrosternal accumulation of pericardial fluid; and in both positions, there is often elevation of the heart above the diaphragm by pericardial fluid. When venous hypertension, prolongation of the circulation (opacification) time, and relatively normal-sized cardiac chambers coexist with the pericardial effusion, effusive-restrictive pericarditis or pericardial effusion with cardiac tamponade should be suspected. Cardiac tamponade can be ruled out by pericardiocenteses, with alleviation of venous hypertension. The absence of cardiac dilatation, a common cause of venous hypertension and prolonged circulation time, can be appreciated after scrutiny of angiocardiograms. The clinical, surgical, and pathologic features of effusive-restrictive pericarditis are described in 6 patients with the syndrome. Early diagnosis of effusive-restrictive pericarditis can be life-saving, and angiocardiography is recommended.