Constrictive pericarditis

Constrictive pericarditis

1. Constrictive pericarditis

2. Outlines: Overview of Constrictive pericarditis. To know the causes of Constrictive pericarditis. Clinical features of patients with Constrictive pericarditis. How to diagnose Constrictive pericarditis. How to treat Constrictive pericarditis.

3. Overview: Constrictive pericarditis: It’s a pericarditis that’s characterized by fibrosis and scaring of the pericardium with subsequent obliteration of the pericardial cavity and impairment of late diastolic filling.

4. Etiology: Idiopathic. Infectious causes: Bacterial, viral, fungal or parasitic. Radiation. Autoimmune disease. Chronic kidney disease: Uremia. Drugs: Hydralazine, procainamide.

5. Pathophysiology: Systole is normal. In the late diastole the ventricles become restricted from filling to the maximum, therefore reduces cardiac output. So patients develop symptoms and sign of RHF and reduces cardiac output.

6. Clinical features: Develops over months to years. ↓ CO: Fatigue, hypotension leads to reflex tachycardia and cachexia. Systemic venous congestion: JVD with Kussmaul sign. Hepatomegaly. Ascites. Diastolic Knock (Pericardial Knock )

7. Diagnosis: EKG. CXR: Calcification. Echocardiogram. CT/MRI: Calcification. Catheterization: Test of choice to confirm the diagnosis.

8. Treatment: Treat the underlying condition: for instance dialysis in patient with CKD (Uremia). Diuretics: to decrease congestion. Surgical pericardiectomy: is the definitive treatment for sever cases.

9. References: Step-up to medicine 5 th edition.