Heart 90:e4 doi:10.1136/heart.90.1.e4
  • Electronic pages

Primary pericardial mesothelioma presenting as pericardial constriction: a case report

  1. S Suman,
  2. P Schofield,
  3. S Large
  1. Departments of Cardiology and Cardiac Surgery, Papworth Hospital, Papworth, Cambridge, UK
  1. Correspondence to:
    Dr Shivani Suman
    Department of Cardiology, Papworth Hospital, Papworth, Cambridge, UK;
  • Accepted 11 July 2003


A 19 year old man presented with a six month history of chest pain, dyspnoea, and lethargy and was found on an echocardiogram to have a dilated left ventricle with a small pericardial effusion. Ramipril and a course of steroids were tried but serial echocardiograms showed a persistently thickened pericardium and slowly developing features of constriction. On computed tomography, a large mediastinal mass encasing the heart, along with para-aortic and paratracheal lymphadenopathy, was found. Right heart catheter studies showed equal pressures in all four chambers. His deteriorating clinical condition led to a pericardiectomy. Histology confirmed primary pericardial mesothelioma. The patient died soon after surgery.