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 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.

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.