Constrictive pericarditis Flashcards
Define:
Chronic inflammation of the pericardium with thickening and scarring of the pericardial layers. Will impair the cardiac function
Aetiology/risk factors:
Often under-diagnosed as present very similar to restrictive cardiomyopathy.
Can occur after any disease and common causes are:
- post operative
- TB
- Viral
- connective tissue disorders
- idiopathic
- mediastinal radiation
Epidemiology:
Rare
more common in males
9% of those with pericarditis will develop constrictive pericarditis
TB has the highest incidence
Symptoms and signs:
gradual onset
advanced - jaundice, cachexia and muscle wasting
signs of right heart failure:
- kussmaul’s sign - paradoxical rise in JVP on inspiration
- raised JVP
- ascites
- peripheral oedema
- pulsatile hepatomegaly
- splenomegaly
- soft heart sounds, s3
- diastolic pericardial knock
- dyspnoea
- soft, diffuse apex beath
Investigations:
CXR - will show a small heart +/- calcification of the pericardium
Echo- diagnostic and can distinguish between restrictive cardiomyopathy
MRI and CT - look at pericardial thickness
Biopsy - if an infective cause is suspected
