Constrictive Pericarditis Flashcards
What is the definition of constrictive pericarditis?
Chronic inflammation of the pericardium with thickening and scarring. It limits the ability of the heart to function normally.
What is the aetiology of constrictive pericarditis?
NOTE: it is often underdiagnosed because it is difficult to distinguish it from restrictive cardiomyopathy and other causes of right heart failure
Can occur after any pericardial disease process
More common causes of pericarditis:
- Idiopathic
- Virus
- TB
- Mediastinal irradiation
- Post-surgical
- Connective tissue disease
What is the epidemiology of constrictive pericarditis?
RARE
Documented in all ages
9% of patients with acute pericarditis will develop constrictive pericarditis
TB has the HIGHEST TOTAL INCIDENCE out of all causes
More common in MALES
What are the presenting symptoms of pericarditis?
Gradual-onset of symptoms
EARLY - symptoms and signs may be very subtle
ADVANCED - jaundice, cachexia, muscle wasting
RIght heart failure signs:
- dyspnoea
- peripheral oedema
- raised jvp
- kussmauls sign
- pulsatile hepatomegaly
What are the appropriate investigations for constrictibr pericsarditis?
CXR - may show calcification of the pericardium
Echocardiogram - usually diagnostic and helps distinguish from restrictive cardiomyopathy
MRI - allows assessment of thickness of pericardium
CT - same role as MRI
Pericardial biopsy - may be indicated (especially if suspected infective cause)
