Constrictive pericarditis


Constrictive pericarditis is a medical condition characterized by a thickened, fibrotic pericardium, limiting the heart’s ability to function normally.


Aetiology

  • IDIOPATHIC (M/C)
  • INFECTIONS
    • Tuberculosis
    • Fungal and parasitic infections
    • Incomplete drainage of purulent pericarditis
  • Chronic pericarditis
  • Postviral pericarditis
  • Postsurgical
  • Post-MI
  • In association with pulmonary asbestos

Pathophysiology

Fibrinization
(Myocardial sac)

Movement restriction
(Myocardium)


Clinical features

Both left sided & right sided heart failure symptoms:

  • Fatigue
  • Swollen abdomen, ascites, hepatosplenomegaly, swelling of legs, peripheral oedema
  • Dyspnea
  • Orthopnea
  • General weakness

Related conditions:

  • Bacterial pericarditis
  • Pericarditis
  • Pericarditis after a heart attack

Diagnosis

Imaging

  • X-Ray chest
    • Pericardial calcification
    • Pleural effusions
  • Echocardiography
    • Changes in cardiac chamber volume
  • CT & MRI

Differential diagnosis

  • Restrictive cardiomyopathy
  • Acute pericarditis
    • Universal ST elevation

Management

  • Pericardiectomy
    • Surgical removal of part or most of the pericardium.

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