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APPLICATION OF CARDIOMEMS BEYOND HEART FAILURE: A CASE STUDY OF CONSTRICTIVE SARCOID PERICARDITIS
Abstract   Peer reviewed

APPLICATION OF CARDIOMEMS BEYOND HEART FAILURE: A CASE STUDY OF CONSTRICTIVE SARCOID PERICARDITIS

Trisha Slehria, Grace Alexander and Serkan Bektur
Journal of the American College of Cardiology, Vol.85(12 Supplement), p.3033
04/2025
DOI: 10.1016/S0735-1097(25)03517-X

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Abstract

Background The use of CardioMEMS is associated with reduced hospitalizations and enhanced quality of life in patients with heart failure (HF). It has potential applications outside of the traditional indication. Case A 70-year-old woman with history of systemic sarcoidosis and CardioMEMS implantation presented with dyspnea on exertion. Despite prior suspicion of constrictive pericarditis, an extensive outpatient evaluation did not show constrictive physiology. Repeat echocardiogram revealed left ventricular (LV) diastolic septal flattening and septal bounce. Catheterization revealed prominent x and y descent in the right atrial pressure tracing, elevated and equalized right ventricular (RV) and LV diastolic pressures with a “square root sign,” and presence of RV and LV discordance with respiratory variation (Figure 1). Decision-making These findings confirmed constrictive sarcoid pericarditis, thus pericardiectomy was performed. Preoperatively, the CardioMEMS device showed the 14-day average pulmonary artery diastolic (PAd) pressure was 26 mm Hg, which decreased to 16 mm Hg postoperatively. Post-pericardiectomy, the CardioMEMS device facilitated long-term monitoring, revealing improvement in PAd pressures. Conclusion This case highlights the diagnostic challenge of constrictive sarcoid pericarditis, evident from the extensive investigation to reach a definitive diagnosis, as well as the potential expansion of CardioMEMS beyond its traditional use.

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