Cardiac fibrosis?

[Steve F.]

Hello,
I am a 43 year old male and  I had been refered to a surgeon at U of M for possible removal of my pericardium.  After a CT of the heart, the surgeon said that there was one area of the pericadium that was thick and it was at the lower right part of the heart, the heart is also a bit enlarged in that same area.  He did not feel however that was causing all the problems, shortness of breath, chest pains, swelling in the ankles.  He is going to do a heart biopsy looking for fibrosis.  I asked if this was the same as plumonary fibrosis which he did not really answer.  He said sometimes the heart will switch good tissue for scar tissue and that will not let the heart work the way it should.  I had a plumonary/stress test done that had to be stopped after riding what would have been equal to climbing a flight of stairs, I was starting to pull oxygen from my musle tissue because the heart could not pump enough.  My question to you would be, is the heart disease that causes fibrosis the same as what causes it in the lungs and what is the prognosis of this type of heart disease?  I know that in the lungs it is not very good.   Thank you

[sheree331]

A related discussion, heart vs lungs was started.

[Cleveland Clinic, MD]

Surgery or biopsy.  Biopsy is done during right heart cath and a thorascope is also a diagnostic option.

[ginny]

Dear Doctor,
I did some reading about restrictive cardiomyopathy and restrictive pericarditis.  This indicated that it is very hard to distinguish between these two disease processes, and it may take surgery to definitively diagnose it.  Do doctors biopsy myocardium/pericardium tissue during catherization(R or L)?
Or do they now do exploratory surgery similar to Laproscopy to distinguish between these disease processes instead of open heart surgery?
Thanks,
Ginny

[Cleveland Clinic, MD]

That's rather a broad question but the simple answer is that some illnesses (e.g. amyloid) can affect multiple organs including the heart and the lungs.  It is also possible there are two separate things going on in the lungs and the heart. I suspect the reason they want the biopsy is that they are not sure what is going on in the heart and want a piece of tissue to help make the diagnosis.  Once the disease is known then prognosis can be determined.