Abnormal left ventricular-left atrial posterior wall contour: a new two-dimensional echocardiographic sign in constrictive pericarditis.

We measured the angle P formed by the junction of the left ventricular and left atrial posterior walls, and also the distances from the ultrasound transducer to the left ventricular posterior wall and left atrial posterior wall (DV and DA), respectively, in the parasternal long-axis two-dimensional echocardiographic view. We studied 23 normal adults and four patient groups with conditions commonly associated with left atrial dilatation: mitral regurgitation (14), mitral stenosis (16), hypertrophic cardiomyopathy (13), and constrictive pericarditis (7). Statistically significant differences were found between the constrictive pericarditis group and each of the other groups. Angle P was less than 150 degrees in 0 of 23 normal individuals, in 0 of 14 with mitral regurgitation, in 1 of 16 with mitral stenosis, in 0 of 13 with hypertrophic cardiomyopathy, and in five of seven with constrictive pericarditis. DA minus DV exceeded 20 mm in 0 of 23 normal individuals, one of four with mitral regurgitation, in 6 of 16 with mitral stenosis, in 0 of 13 with hypertrophic cardiomyopathy, and in five of seven patients with constrictive pericarditis; We conclude that angle P greater than 150 degrees suggests constrictive pericarditis; DA minus DV greater than 20 mm suggests constrictive pericarditis if mitral stenosis can be excluded.