1. Constrictive Pericarditis Masquerading as Chronic Idiopathic Pleural Effusion: Importance of Physical Examination 
Mohammed W. Akhter, MD, Ismael N. Nuño, MD, Shahbudin H. Rahimtoola, MD, DSc (Hon) 
The American Journal of Medicine 
Volume 119, Issue 7, Pages e1-e4 (July 2006)
DOI: /j.amjmed
Copyright © 2006 Elsevier Inc. Terms and Conditions

2. Figure 1
A: Right atrial (RA) and pulmonary artery (PA) wedge (indirect left atrial) pressures are elevated. Because of respiratory variation, the PA wedge pressure is higher at times, but the mean RA pressure is 18 mm Hg and the mean pulmonary artery wedge pressure is 20 mm Hg. The “x” descent is more prominent than the “y” descent. B: Simultaneous left ventricle (LV) and right ventricle (RV) pressure tracings show that the diastolic pressures are similar (difference is ∼2-3 mm) and exhibit the ventricular “square root” sign best seen in the first and fourth diastolic periods. Diastolic RV and LV pressure are the same as atrial pressures (18-20 mm Hg).
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3. Figure 2
Abnormally thickened (5-7 mm) pericardium that was removed by pericardiectomy.
The American Journal of Medicine  , e1-e4DOI: ( /j.amjmed )
Copyright © 2006 Elsevier Inc. Terms and Conditions

4. Figure 3
Diagrammatic illustration of the abnormal hemodynamics. The sizes of the circles represent the increases and decreases of venous return. The sizes of the arrows represent the increases and decreases of flow. The broken arrows indicate retrograde flow. The thick black line outside the heart represents rigid pericardium. SVC = superior vena cava; IVC = inferior vena cava; HV = hepatic vein. Please see text for additional abbreviations.
The American Journal of Medicine  , e1-e4DOI: ( /j.amjmed )
Copyright © 2006 Elsevier Inc. Terms and Conditions