Chronic constrictive pericarditis associated with asbestosis

Our plain-English summary of Chronic constrictive pericarditis associated with asbestosis, by L. Fischbein, M. Namade, R.N. Sachs, et al (Chest, 1988).

The study

• Authors: L. Fischbein, M. Namade, R.N. Sachs, M. Robineau, J. Lanfranchi
• Journal: Chest
• Published: 1988;94(3):646-7
• Type of article: Case report
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000905).

Abstract

Observation of chronic constrictive pericarditis associated with pulmonary asbestosis is reported here. Heart catheterization revealed typical patterns of cardiac constriction. The diagnosis of asbestosis was based on pathologic features associated with a long history of asbestos dust exposure without evidence for tuberculosis. The etiology of this constrictive pericarditis was related to an asbestosis pericarditis involvement.

In plain English

This was a case report describing one man with chronic constrictive pericarditis alongside pulmonary asbestosis. In this condition the sac around the heart becomes thickened or calcified and restricts the heart's filling. The man, aged 82, was hospitalized in 1984 with symptoms of cardiac insufficiency. He had worked in boiler construction for 38 years, and his asbestos exposure ended in 1962. A lung carcinoma had been found a year earlier but was not treated because of his age. Imaging showed calcifications of the pericardium and the pleura over the diaphragm. Heart catheterization showed a pattern of cardiac constriction. Tuberculosis tests were negative. He did not have surgery because of the risk at his age and was given diuretics. He died in 1986 after a sudden one-sided paralysis followed by coma. At autopsy, the pericardium was thick and calcified. There was moderate fibrosis in the lower lungs and no mesothelioma. Asbestos bodies were found in lung tissue but not in the pericardial plaques. The authors related the pericarditis to asbestosis affecting the pericardium. They said they knew of no earlier reported case of constrictive pericarditis with asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 82-year-old man hospitalized in 1984 with symptoms of cardiac insufficiency, reported by physicians at Hôpital Avicenne, Bobigny, France
• Exposure: Occupational asbestos dust exposure from 38 years of work in boiler construction, ending in 1962; fiber type not stated
• Main results:
  • Chest radiography showed calcifications of the pericardial and diaphragmatic pleurae
  • Echocardiography confirmed thickening of the pericardium and showed a dilated inferior vena cava
  • Heart catheterization showed a 'dip-plateau' pattern of restricted filling extending to the left side of the heart, with right atrial pressure of 20 mm Hg
  • The PPD skin test and the sputum cultures for mycobacteria were negative
  • The patient was not operated on because of surgical risk at his age and was treated with diuretics
  • In 1986 the patient was hospitalized again with sudden hemiplegia, followed by coma and death
  • Autopsy found an adenocarcinoma of the left upper lobe of the lung
  • Autopsy found fibrohyaline plaques covering the diaphragmatic pleura and extending to the liver and pericardium; the pericardium was thick and calcified
  • Moderate interstitial fibrosis was found only in the lower lobes, and there was no mesothelioma
  • Asbestos bodies were present in the lung tissue but absent in the pericardial plaques, and no sign of tuberculosis was found
• The authors' conclusion: The authors related this constrictive pericarditis to asbestosis involving the pericardium. They stated that, to their knowledge, constrictive pericarditis had not previously been reported with asbestos exposure.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Asbestosis, Etiology.

Related studies

• Constrictive pericarditis after left extrapleural pneumonectomy and radiotherapy for malignant mesothelioma — E.J. Hickey, A.A. Khan, et al. (2007)
• Constrictive pericarditis in a patient with fiberglass lung disease: a case report — C.Y. Hsu, H.Y. Chen, et al. (2024)
• Asbestos induced pericardial effusion and constrictive pericarditis — D. Davies, M.I. Andrews, et al. (1991)
• Pericardiectomy for treatment of neoplastic constrictive pericarditis — F. Buyukbayrak, E. Aksoy, et al. (2014)
• 18F-FDG PET/CT Revealing Constrictive Pericarditis as the Only Manifestation of Malignant Mesothelioma — J.P. Edel, H. Balink (2019)
• A case of pleural mesothelioma with effusive-constrictive pericarditis — N.A. Weir, B. Gerstenhaber (2001)

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