Edema and protein-losing enteropathy complicating chronic constrictive pericarditis associated with an ascending aortic aneurysm

Edema and protein-losing enteropathy complicating chronic constrictive pericarditis associated with an ascending aortic aneurysm

Presse Med. 2007 Nov 5

Lesaffre F, Sandras R, Saade YA, Duval S, Metz D.
Département de cardiologie et pathologies vasculaires, CHU de Reims, Hôpital Robert Debré, Avenue du Général Koenig, F-51100 Reims, France.

INTRODUCTION:

Chronic constrictive pericarditis is suspected on clinical and echocardiographic grounds. Its treatment is surgical. CASE: We report here the case of a 45-year-old man, admitted for edema characteristic of lymphatic obstruction. Examination revealed ascending aorta ectasia, associated with chronic constrictive pericarditis. Measurement of alpha-1 antitrypsin clearance confirmed protein-losing enteropathy. Total recovery followed pericardectomy and aneurysm resection.

DISCUSSION:

The clinical edema in this case was due to several phenomena: protein-losing enteropathy from a functional lymphatic overload, induced by chronic constrictive pericarditis and by compression of the right atrium and vena cava by an aortic aneurysm. The hypoalbuminemia induced by protein loss may also magnify edema. An association between chronic constrictive pericarditis and ascending aortic aneurysm is uncommon. No cause for this association was found.

PMID: 17988828 [PubMed - as supplied by publisher]