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Pınar Türker, Serkan Duyuler, Sinan Cerşit, Omaç Tüfekçioğlu, Rıza Sarper Ökten, A rare consequence of blunt chest trauma: dumbbell heart with calcified pericardial band at the mid-ventricular level, European Heart Journal - Cardiovascular Imaging, Volume 14, Issue 3, March 2013, Page 298, https://doi.org/10.1093/ehjci/jes203
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A 36-year-old female patient was admitted to our clinic with chronic atypical chest and back pain. She had a history of 3-day hospitalization in the intensive care unit after a severe blunt chest trauma in a car accident 25 years ago. She had no clear evidence of bloody pericardial effusion or pericardial intervention. The heart was observed to have regular rhythm without any murmur, rub, or gallop. Lung fields were clear. Electrocardiography demonstrated sinus rhythm along with non-specific ST-T wave changes. Transthoracic echocardiography depicted dumbbell-shaped ventricles with a circular calcification at the mid-ventricular level (Panel 1A and B and see Supplementary data online, Movie S1). However, Doppler echocardiographic evaluation did not reveal any finding compatible with constriction. CT depicted a calcified pericardial band (CPB) encircling both of the left and right ventricles at the mid-ventricular level, including anterior descending and right coronary arteries (Panel 1C and D and see Supplementary data online, Movie S2). Since CT could not rule out the presence of pericardial constriction and coronary impingement incurred by the pericardial ring, a complete heart catheterization was scheduled. Heart catheterization confirmed the absence of constrictive pericarditis and coronary impingement (Panel 1E and F and see Supplementary data online, Movie S3). Tuberculin skin test and radiologic images were negative for tuberculosis. The patient was placed on a follow-up programme for the possibility that constrictive pericarditis may ensue. Moreover, she was consulted to physical therapy physician for back pain.