Constrictive pericarditis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Symptoms similar to [[congestive heart failure]], especially right sided | *Symptoms similar to [[congestive heart failure]], especially right sided | ||
**Dyspnea | **[[Dyspnea]] | ||
**Lower extremity edema | **Lower extremity edema | ||
**Jugular venous distention | **Jugular venous distention | ||
| Line 45: | Line 45: | ||
*BNP | *BNP | ||
*[[Ultrasound]] | *[[Ultrasound]] | ||
**Formal TTE/TEE | **Formal [[echocardiography|TTE/TEE]] | ||
===Diagnosis=== | ===Diagnosis=== | ||
Revision as of 15:59, 8 February 2021
Background[1]
- Occurs when normally elastic pericardium becomes thickened and fibrotic
- Can be infectious, post-cardiac surgery, inflammatory, idiopathic or related to radiation exposure
- Impairs diastolic filling of heart
- Must distinguish from restrictive cardiomyopathy
Clinical Features
- Symptoms similar to congestive heart failure, especially right sided
- Dyspnea
- Lower extremity edema
- Jugular venous distention
Differential Diagnosis
Cardiomyopathy
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy
- Peripartum cardiomyopathy
- Takotsubo cardiomyopathy
- Arrhythmogenic right ventricular dysplasia
- Cardiovascular
- Pulmonary
- Other
- Pure volume overload
- Renal Failure
- Post-Transfusion
- Sepsis
- Anaphylaxis
- Pure volume overload
Evaluation
Workup
- CBC
- Chemistry
- ECG
- CXR
- Troponin/CK
- BNP
- Ultrasound
- Formal TTE/TEE
Diagnosis
Management
- Definitive treatment is surgical pericardiectomy
Disposition
See Also
External Links
References
- ↑ Singh M, Niemann JT. Cardiomyopathies and Pericardial Disease. In: Tintinalli JE, Ma OJ, Yealy DM, et al., eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 9th ed. McGraw-Hill; 2020:(Ch) 55.