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
Investigations:
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%
