A Case of Cardiac Constriction

A 69-year-old woman with asbestos exposure presents with Dyspnea. Explore the diagnosis behind ventricular interdependence and the ‘square root’ sign.

Constrictive Pericarditis


A 69-year-old woman with a history of asbestos exposure presented to the emergency department with a 3-year history of dyspnea on exertion. Physical examination showed signs of volume overload. A chest radiograph showed circumferential calcification of the pericardium and pleural effusions. Simultaneous left and right heart catheterization showed ventricular interdependence and discordance of the pressure tracings (right ventricular pressure, solid arrow; left ventricular pressure, dotted arrow). What is the diagnosis?

What is the most likely diagnosis?

Cardiac Tamponade
Constrictive Pericarditis
Effusive-Constrictive Pericarditis
Primary Pericardial Mesothelioma
Restrictive Cardiomyopathy

Asbestosis, Constrictive Pericarditis, Dyspnea, Heart Catheterization, Pericardial Calcification

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