Constrictive Pericarditis
Revision as of 18:48, 7 December 2022 by Kennybroccoli (talk | contribs) (Created page with "==Background== *Result of scarring and loss of elasticity of the pericardial sac *Typically chronic complication of pericarditis ==Clinical Features== *Pleuritic chest pain *Dyspnea *Malaise *Characteristic symptoms of pericarditis less frequent in recurrent presentations ==Differential Diagnosis== ==Evaluation== ===Workup=== *Initial evaluation: **ECG: No pathognomonic findings, however may be associated with nonspecific ST and T wave changes, atrial fibrill...")
Background
- Result of scarring and loss of elasticity of the pericardial sac
- Typically chronic complication of pericarditis
Clinical Features
- Pleuritic chest pain
- Dyspnea
- Malaise
- Characteristic symptoms of pericarditis less frequent in recurrent presentations
Differential Diagnosis
Evaluation
Workup
- Initial evaluation:
- ECG: No pathognomonic findings, however may be associated with nonspecific ST and T wave changes, atrial fibrillation, and low voltage [1]
- CXR: Ring of calcification around the heart, however the majority of patients will not have this
- TTE
- Advanced evaluation:
- Cardiac CT/MR
- Invasive hemodynamic evaluation
Diagnosis
- No single diagnostic imaging/evaluation parameter
- Must be differentiated from tamponade and disorders such as restrictive cardiomyopathy as management is different for each of these pathologies
Management
- If no signs of chronic process: Medical management (Colchicine, NSAIDs for 2-3 months)
- Chronic signs: Anasarca, cachexia, atrial fibrillation, hepatic dysfunction, pericardial calcification
- If chronic process: Pericardiectomy [2]
Disposition
- Admit
See Also
External Links
References
- ↑ Talreja DR, Edwards WD, Danielson GK, Schaff HV, Tajik AJ, Tazelaar HD, Breen JF, Oh JK. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation. 2003 Oct 14;108(15):1852-7. doi: 10.1161/01.CIR.0000087606.18453.FD. Epub 2003 Sep 29. PMID: 14517161.
- ↑ Welch TD. Constrictive pericarditis: diagnosis, management and clinical outcomes. Heart. 2018 May;104(9):725-731. doi: 10.1136/heartjnl-2017-311683. Epub 2017 Nov 25. PMID: 29175978.