Constrictive pericarditis

Question 1

Causes?

Answer 1

• any cause of pericarditis

- particularly TB

Question 2

Features?

Answer 2

• dyspnoea
• right heart failure: elevated JVP, ascites, oedema, hepatomegaly
• JVP shows prominent x and y descent
• Kussmaul’s sign is positive

Question 3

What is seen on chest x-ray?

Answer 3

Pericardial calcification

Question 4

What are the key differences between this condition and cardiac temponade?

Answer 4

Cardiac tamponade:

• Absent Y descent
• Pulsus paradoxus present
• Kussmaul’s sign is rare

Constrictive pericarditis:

• X + Y present
• Pulsus paradoxus absent
• Kussmaul’s sign present
• Characteristically has pericardial calcification on chest x-ray

Question 5

What sound may be heard in this condition?

Answer 5

Pericardial knock - loud S3