Constrictive Pericarditis Flashcards
Define constrictive pericarditis
DEFINITION: chronic inflammation of the pericardium with thickening and scarring. It limits the ability of the heart to function normally.
Explain the aetiology/risk factors of constrictive pericarditis
- Often underdiagnosed
- Difficult to disinguish it from restrictive cardiomyopathy and other causes of right heart failure distinguish
Can occur after any pericardial disease process
More common causes of pericarditis:
Idiopathic
Virus
TB
Mediastinal irradiation
Post-surgical
Connective tissue disease
Summarise 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
Recognise the presenting symptoms and signs of constrictive 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
Kussmaul’s sign (paradoxical rise in JVP on inspiration)
Pulsatile hepatomegaly
Identify appropriate investigations for constrictive pericarditis
CXR Echocardiogram MRI CT Pericardial biopsy
CXR
may show calcification of the pericardium
Echocardiogram
usually diagnostic and helps distinguish from restrictive cardiomyopathy
MRI
allows assessment of thickness of pericardium
CT
allows assessment of thickness of pericardium
Pericardial biopsy
may be indicated (especially if suspected infective cause)
