Case Session 03: Pericardial Disease (2018)-Complex pericardial cyst and congestive hepatopathy: The role of cardiac MRI with pathologic validation

Complex pericardial cyst and congestive hepatopathy: The role of cardiac MRI with pathologic validation

Video Transcription

Video Summary

A 53-year-old man with presumed cirrhosis and refractory ascites was evaluated for liver transplant but found to have diffuse pericardial calcification and signs of constrictive pericarditis. Cardiac MRI revealed a large complex pericardial cyst with thrombus, pericardial enhancement, septal bounce, and right atrial involvement. He also had bacterial peritonitis, nonobstructive coronaries, worsening renal failure, and ultimately septic shock with multiorgan failure. Autopsy showed a large hemorrhagic pericardial cyst causing constrictive physiology and congestive hepatopathy, with nodular regenerative hyperplasia rather than cirrhosis. The case highlights the diagnostic value of cardiac MRI in complex pericardial disease.

Keywords

constrictive pericarditis

pericardial cyst

cardiac MRI

congestive hepatopathy

nodular regenerative hyperplasia