Constrictive Pericarditis

Constrictive Pericarditis

Pathology:  Results from thickening and scarring ofthe pericardial sac, the fibrotic pericardium therefore loses its elasticityand prevents the heart from expanding


Aetiology:  Idiopathic, radiation, TB, prior trauma


Symptoms:   Shortness ofbreath, symptoms of right heart failure


Signs:  Low volume pulse, Elevated JVP,raised ‘x’ and ‘y’ descents, Kussmaul’s sign, pericardial knock, pulsus paradoxus,hepatomegaly, ascites, impalpable apex beat, hypotension, quiet heart sounds



Chest X-Ray: pericardial calcification or pleural effusions

ECG: Small QRS complexes

Echo: reduced end-diastolic volumes and raised diastolic pressures, pericardial

thickening may be seen

                                          CT/MRI: Pericardial thickening andcalcification can be assessed

                                          Cardiac Catheterisation: Differingright and left ventricular pressures


Treatment:  Definitive treatment ispericardiectomy


Complications:        AF


Prognosis:  Poorprognosis even after pericardiectomy. Peri-operativemortality 10%

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