Constrictive Pericarditis

Question 1

Causes of Constrictive pericarditis

Answer 1

Tumour
Tuberculosis
Therapy (radio)
Trauma (post MI/ sternotomy)
Tissues (connective tissues disease such as SLE/RA)

other uraemia, hydralazine, procainamide

Question 2

Symptoms of constrictive pericarditis

Answer 2

SOB
Palpitations
Reduced ETT
PND/Orthopnoea
fatigue
Oedema

Question 3

Signs of constrictive pericarditis (non auscultation)

Answer 3

Low volume pulse
JVP - prominent X + Y decent
Radiation tattoo
Hepatomegaly and ascities
Kussmauls sign
Pulsus paradoxicus (BP falls on inspiration and may lose pulse)
CLD signs

Question 4

Auscultation of constrictive pericarditis

Answer 4

Wide S2
Tricuspid regurg
S3 sound

Question 5

Investigations of constrictive pericarditis

Answer 5

ECG
CXR
TTE
Cardiac catheterisation
Cardiac CT

Question 6

Signs on ECG for constrictive pericarditis

Answer 6

P-pulmonale/ p-Mitrale/ AF

Question 7

CXR of constrictive pericarditis

Answer 7

Calcification of pericardium/ Old TB

Question 8

TTE of constrictive pericarditis

Answer 8

Thickened pericardium/ LA enlargement/ TR/ equalisation of LV and RV pressures

Question 9

Management of constrictive pericarditis

Answer 9

Steroids in TB
Medical management of HF/ overload
Surgical: pericardiectomy