Constrictive Pericarditis

Question 1

def

Answer 1

chronic inflammation of the pericardium leading to thickening + scarring which limits heart functioning

Question 2

aetiology

Answer 2

1 idiopathic
2 heart surgery
3 radiation therapy to the chest (lung cancer)
4 TB

Question 3

epi

Answer 3

10% of patients with acute pericarditis will develop constrictive pericarditis
males>females
20-60yrs

Question 4

history

Answer 4

1 dyspnoea
2 ankle oedema
3 abdominal distension due to ascites + hepatomegaly

Question 5

why should you ask about absestos exposure

Answer 5

asbestos exposure can cause mesothelioma which is a rare cause of constrictive pericarditis

Question 6

examination

Answer 6

1 kussmauls sign
2 weak heart sounds
3 hepatomegaly
4 ascites
5 peripheral oedema

Question 7

what is kussmauls sign

Answer 7

raised JVP on inspiration

due to limited RV filling

Question 8

investigations

Answer 8

1 ECG
-low-voltage QRS
-T wave inversion
-AF in chronic CP
2 CXR
-normal cardiac size with venous distension/HF is suggestive of CP or restrictive cardiomyopathy
-pericardial calcification is diagnostic
3 echo/CT/MRI
-pericardial thickening