Constrictive Pericarditis

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Constrictive Pericarditis


  • after Pericarditis pericardium may be thickened, fibrous and calcified
  • restricts filling of heart

History

  • preceding episode of pericarditis
  • fatigue
  • excercise intolerance

Examination

  • systemic venous congestion
    • ascites
    • dependant oedema
    • hepatomegaly
    • pulmonary venous distension
  • little pulmonary congestion
  • Atrial Fibrillation (30%)
  • loud third heart sound

Investigations

  • CXR
    • relatively small heart
    • obvious calcification on lateral film
  • ECG
    • low QRS voltages
    • T wave inversion
  • Echocardiogram
    • thickened pericardium
    • relative immobility
    • small ventricluar cavities
      • wall thickness normal
    • dilated atria
  • CT scan
 

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