Constrictive pericarditis

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[edit] Discussion of Constrictive pericarditis

  • Causes of constrictive pericarditis:
    • Most frequent causes are cardiac surgery and radiation therapy.
    • Other causes include infection (viral or tuberculosis), connective-tissue disease, uremia, neoplasm, or idiopathic condition.
  • Present with symptoms of heart failure, such as dyspnea, orthopnea, and fatigability, and occasionally may present with hepatomegaly and ascites.
  • Clinically, it is difficult to differentiate between constrictive pericarditis and restrictive cardiomyopathy.
    • These two entities are characterized by similar clinical manifestations and similar findings at cardiac catheterization and echocardiography.
    • In both conditions, ventricular filling is restricted, leading to an increase in diastolic pressure in all four cardiac chambers and to equalization of atrial and ventricular pressure.
  • It is important to distinguish between constrictive pericarditis and restrictive cardiomyopathy as with constrictive pericarditis might benefit from pericardial stripping, whereas those with restrictive disease would not.

[edit] Imaging Findings for Constrictive pericarditis

  • Normal pericardial thickness is less than 2 mm.
  • Pericardial thickness of 4 mm or more indicates abnormal thickening and, when it is accompanied by clinical findings of heart failure, is highly suggestive of constrictive pericarditis.
  • CT has a high sensitivity in depicting pericardial calcification, which is associated with constrictive pericarditis.
  • Neither pericardial thickening nor calcification is diagnostic of constrictive pericarditis unless the patient also has symptoms of physiologic constriction or restriction.

  • Systemic venous dilatation, hepatomegaly, and ascites also are frequently seen.
  • Central cardiovascular structures may show a characteristic morphology in constrictive pericarditis.
    • Right ventricle tends to have a reduced volume and a narrow tubular configuration.
    • In some patients, a sigmoid-shaped ventricular septum or prominent leftward convexity in the septum can be observed.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References for Constrictive pericarditis