CHRONIC CONSTRICTIVE PERICARDITIS

Constrictive pericarditis —

Constrictive pericarditis is the result of scarring and consequent loss of elasticity of the pericardial sac. The normal pericardium is a fibroelastic sac containing a thin layer of fluid that surrounds the heart.

  • After the absorption of ericardial fluid thereis orga­nization of fibrin, serous fluid and granulation tissue In t e pericardium.
  • This results in a thickening, scar formation, harden­ing and constriction of pericardium.
  • Causes are – tuberculosis, trauma, irradiation, tu­~ors, SLE, uraemia.

CHRONIC CONSTRICTIVE PERICARDITIS

CHRONIC CONSTRICTIVE PERICARDITIS

   

CHRONIC CONSTRICTIVE PERICARDITIS Physical findings :

 

  • JVP is raised – x and y descent are prominent
  • Ascites, Edema, Anasarca and Hepatomegaly
  • Pulsus parodoxus
  • Kussmaul’s sign – increased JVP during inspira-
  • tion i.e. rise of venouscolumn in the neck dur­ing inspiration instead of a fall is called Russmaul’SSi n
  • Pericardial knock -is an extra sound after sec­ond heart sound
  • Atrial fibrillation may be present.

 

CHRONIC CONSTRICTIVE PERICARDITIS

CHRONIC CONSTRICTIVE PERICARDITIS

   

X-ray I echocardiogram I CT scan I MRI

  • Thickening, calcification, scarring of pericardium is seen.

CHRONIC CONSTRICTIVE PERICARDITIS Treatment

  • Resection of pericardium. Mortality may be high depending on myocardial atrophy.
  • Treatment of etiology.

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