Constrictive pericarditis

Question 1

define constrictive pericarditis?

Answer 1

• chronic inflammation of the pericardium with thickening and scarring.
• It limits the ability of the heart to function normally

Question 2

what are common causes of pericarditis?

Answer 2

Idiopathic
Virus
TB
Mediastinal irradiation
Post-surgical
Connective tissue disease

Question 3

what is the epidemiology of constrictive pericarditis?

Answer 3

• it is RARE
• seen in all ages
• can be seen in cases of acute pericarditis
• more common in males
• common after TB

Question 4

what is the nature of onset of constrictive pericarditis?

Answer 4

• gradual onset

- early signs can be very subtle

Question 5

what are the signs of advanced constrictive pericarditis?

Answer 5

Dyspnoea
Peripheral oedema
Raised JVP
Kussmaul's sign (paradoxical rise in JVP on inspiration)
Pulsatile hepatomegaly
jaundice 
cachexia

Question 6

what investigations should be carried out for constrictive pericarditis?

Answer 6

CXR - calcification of the pericardium
Echocardiogram
MRI- assesses thickness of pericardium
Pericardial biopsy- infective cause