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constrictive pericarditis


  • scarring and consequent loss of the normal elasticity of the pericardial sac results in impaired ability of the heart to expand and fill with blood, this is termed constrictive pericarditis and needs to be differentiated from:
    • cardiac tamponade which is the restriction of cardiac filling due to increased fluid in the pericardial sac
    • restrictive cardiomyopathy


clinical features

  • symptoms of low cardiac output such as fatiguability or SOBOE
  • raised JVP
  • pulsus paradoxus in 20%
  • Kussmaul's sign (the lack of an inspiratory decline in JVP) in ~20% but also occurs in severe TI or RVF
  • ECG is non-specific
    • nonspecific ST and T wave changes and tachycardia are common, and low voltage may sometimes be present
  • CXR
    • may demonstrate a ring of calcification around the heart, best seen on lateral or anterior oblique projections
  • echo is the definitive Ix to confirm diagnosis
pericarditis_constrictive.txt · Last modified: 2013/07/19 16:05 (external edit)