A case study demonstrated that mixed martial arts (MMA) is an unrecognized risk factor for constrictive pericarditis (CP). The results appeared in BMC Cardiovascular Disorders.
The case involved a 47-year-old White male former MMA fighter from the Western United States who presented to a liver clinic with elevated liver injury tests (LIT). He had lost 35 pounds associated with diarrhea, had lower extremity edema, dyspnea on exertion, and worsening fatigue over a six-month duration. His medical history included concussion, right bundle branch block, migraine headache, hypertension, chronic pain related to musculoskeletal injuries, and fractures secondary to MMA competition. He was a veteran in MMA, with an eight-year history of professional matches, and a 13-year history of MMA fighting with recurrent trauma to the chest wall. He also reported a 20-year history of performance enhancing drugs, including testosterone.
Upon physical exam, the patient had elevated jugular venous pressure, hepatomegaly, and trace peripheral edema. He underwent laboratory studies, abdominal computerized tomography, liver biopsy, echocardiogram, and cardiac magnetic resonance imaging. Right and left heart catheterization confirmed discordance of the right ventricle-left ventricle, consistent with constrictive physiology. The patient then underwent pericardiectomy, and eventually returned to NYHA functional class I.
“CP can be a sequela of recurrent pericarditis or hemorrhagic effusions and may have a delayed presentation. In cases of recurrent trauma, CP may be managed with pericardiectomy with apparent good outcome,” the researchers concluded. They added that future studies “are warranted to analyze the occurrence of CP in MMA so as to better define the risk in such adults.”
Keywords: Case report, Constrictive, Diastolic heart failure, Hemodynamics, Imaging