Introduction
Constrictive pericarditis is characterised by a thickened, fibrotic and calcified pericardium. This limits ventricular filling and may result in heart failure. These changes are chronic and symptoms do not appear for a relatively long time.
Causes
Clinical features
Symptoms
- Fatigue
- Dyspnoea
- Peripheral oedema
Signs
Investigations
- ECG: low voltage QRS complexes, generalised T wave inversion
- Chest x-ray: small heart in the context of heart failure, pericardial calcification
- Echocardiography: thickened, calcified pericardium with normally contracting ventricles (unlike restrictive cardiomyopathy)
- Endomyocardial biopsy: can distinguish it from restrictive cardiomyopathy
Management
Surgical excision of the pericardium (pericardiectomy).
Prognosis
Overall, prognosis is poor.
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