Condition- Constrictive pericarditis

Question 1

What is contrictive pericarditis?

Answer 1

Chronic inflammation of the pericardium with thickening and scarring of the pericardial layers. It limits the diastolic function of the heart , as it is encased in a rigid pericardium

Question 2

Which heart condition might constrictive pericarditis be confused for?

Answer 2

Restrictive cardiomyopathy

Question 3

What is the most common cause of constrictive pericarditis?

Answer 3

TB

Question 4

Describe the presenting symptoms and signs of someone with constrictive pericarditis…

Answer 4

• Gradual onset
• Right heart failure signs:
  
  • SOB
  • Peripheral Oedema
  • Ascites
  • hepatosplenomegaly –> jaundice, cachexia
  • Raised JVP
  • Kussmaul’s sign
  • Soft, diffuse apex beat
  • Quiet heart sounds + S3
  • Diastolic pericardial knock

Question 5

Which investigations would be performed to identify if someone had constrictive pericarditis? What would be the results of these?

Answer 5

• CXR: small heart +/- calcification of pericardium
• Echo: diagnostic to differentiate from restrictive cardiomyopathy
• MRI: to assess thickness of pericardium