chronic constrictive pericarditis or pick disease.ppt

Academic purpose of content

1. CHRONIC CONSTRICTIVE PERICARDITIS
OR
PICK’S DISEASE
Dr.A.S.SHIVA SARAVANAN,M.D(HOM)
PROFESSOR
DEPARTMENT OF SURGERY
VMHMC
SALEM

2. AETIOLOGY
•The cause is unknown in majority of cases.
–The disease often represents the end stage of an
undiagnosed viral pericarditis.
–Tuberculosis was considered to be the most
frequent cause but in recent years it is almost
unknown.
–Traumatic haemopericardium may evolve to
constrictive pericarditis.
–It may be a complication of open heart surgery.

3. PATHOLOGY
•Pericardium becomes thickened, fibrosed and
calcified. The pericardial cavity is obliterated by
dense scar tissue. The heart is in fact is confined in a
rigid case preventing it from its proper functioning.
•Pathological effect of this condition is that it
prevents ventricles from proper filling in diastole.
This causes decreased cardiac output.
•A compensatory tachycardia is seen.
•There is corresponding increase in right atrial
pressure and right ventricular diastolic pressure.
•There is also elevation of central venous pressure.
The venous hypertension may produce peripheral
oedema, hepatic enlargement and ascites.

4. CLINICAL FEATURES
•The disease is usually seen in 2
nd
or 3
rd
decade.
•Fatigue and dyspnoea on exertion are common
complaints.
•Gradually complains of oedematous swelling of the
feet and abdominal enlargement due to ascites.
•On examination, peripheral oedema, enlargement
of liver and ascites should be detected. Dilatation of
peripheral veins are also noticed.
•The pulse pressure is normally decreased and a
paradoxic pulse is found a small percentage of
cases.

5. Treatment
•Pericardiectomy

6. Thank you . . . . . ..