Constrictive Pericarditis
| Constrictive pericarditis | Asbestos-related, drugs (amiodarone, nitrofurantoin) |
Constrictive Pericarditis
- Fibrotic thickening and scarring of pericardium → restricts cardiac filling
- Heart encased in dense fibrous shell
- Causes: TB (most common globally), previous viral/bacterial pericarditis, cardiac surgery, radiation
- Mimics restrictive cardiomyopathy
- Distinction from RCM: pericardium thickened on imaging/CT; calcification may be visible; treated by pericardiectomy
Read this in CARDIOVASCULAR PATHOLOGY
Constrictive Pericarditis
- Fibrous scarring of pericardium → impairs filling
- Causes: TB ( 1 worldwide), viral, radiation
- Kussmaul sign (JVP rises on inspiration)
- Pericardial knock on auscultation
Read this in Comprehensive Heart Pathology Notes 🫀
What our notes say
- | Constrictive pericarditis | Asbestos-related, drugs (amiodarone, nitrofurantoin) | (Pleural Effusion)
- Posthepatic: Budd-Chiari syndrome, constrictive pericarditis and right heart failure. (Junior Clerkship in Internal Medicine (MBIM4100) main exam, Paper One: 31 Januar)
- Post-sinusoidal: veno-occlusive disease; Budd-Chiari syndrome (hepatic vein thrombosis or obstruction of outflow); constrictive pericarditis and right heart failure; inferior vena cava webs and primary vascular malignancies. (Internal Medicine 4th Year 1st Semester CAT: HIV and the gut, liver disease and )
- Cardiomyopathy , Pericardial effusion, Constrictive pericarditis (Examination of Respiratory system — Past Paper Questions & Answers)
- | Restricted filling | Mitral stenosis, constrictive pericarditis, restrictive cardiomyopathy, hypertrophic cardiomyopathy | (CVS History & Physical Exam: Symptoms, Chest Pain & Syncope)
- Elevated in constrictive pericarditis, restrictive cardiomyopathy, left ventricular failure (Cranial Nerves, Eye Exam & Vital Signs: MBChB Clinical Revision)
Study material on Constrictive Pericarditis
- 🫀 MISSING TOPICS — ULTRA DEEP NOTES
- Cardiovascular system examination revised 2012
- Examination of Respiratory system
Practice questions on Constrictive Pericarditis
72-year-old, constrictive pericarditis, pericardiectomy shows dense fibrous thickening with calcification. Expected hemodynamic feature?
- Massive pericardial effusion with RV chamber collapse
- Elevated PCWP with normal RA pressure
- Low central venous pressure with high cardiac output
- Normal JVP with exertional hypotension
- Equalization of diastolic pressures across all four cardiac chambers
Answer: E. - The rigid, non-compliant pericardium restricts filling equally in all chambers → classic **equalization of diastolic pressures** (RA = RV = PCWP) ---
A 72-year-old male with constrictive pericarditis undergoes pericardiectomy. The resected pericardium shows dense fibrous thickening with areas of calcification. Which of the following hemodynamic features would be EXPECTED in this patient?
- Elevated PCWP with normal RA pressure
- Equalization of diastolic pressures across all four cardiac chambers
- Low central venous pressure with high cardiac output
- Massive pericardial effusion with RV chamber collapse
- Normal JVP with exertional hypotension ✅ Answer: B
Answer: A. Equalization of diastolic pressures (right atrial, right ventricular, pulmonary artery diastolic, and pulmonary capillary wedge pressures) is a hallmark hemodynamic finding in constrictive pericarditis.