Chronic Expanding Hematoma with Constrictive Pericarditis

Masaki Komatsu＊	Kazuki Naito＊	Shuji Chino＊
Haruki Tanaka＊	Hajime Ichimura＊	Takateru Yamamoto＊
Kou Nakahara＊	Megumi Fuke＊	Yuko Wada＊
Tatsuichiro Seto＊

(Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine＊, Matsumoto, Japan)

We report the successful treatment of a rare case of chronic expanding hematoma and visceral pericardium thickening constrictive pericarditis with no history of trauma or surgery. A 70-year-old woman, who had no history of trauma or surgery was admitted for exertional dyspnea. An echocardiographic study demonstrated a mass located anterior to the right ventricle that severely compressed the right ventricle toward the ventricular septum. Enhanced chest computed tomography demonstrated pericardial calcification and a 125-mm heterogeneous mass in the middle mediastinum. A mosaic pattern was seen on T1, T2-weighted magnetic resonance imaging. Surgical resection of the mass and removal of the visceral pericardium were planned to treat heart failure and to confirm the diagnosis of the mass. The mass was old degenerated coagula. Histopathological examination confirmed the diagnosis of chronic expanding hematoma. The postoperative course was uneventful. There has been no sign of recurrence 19 months after the operation.

 

Jpn. J. Cardiovasc. Surg. 51 : 105-109 （2022）

Keywords：chronic expanding hematoma ; constrictive pericarditis ; heart failure