Pericarditis constrictiva konstriktorische perikarditis pseudoleberzirrhose, perikarditische. Jan 26, 2011 pericarditis constrictiva is caused by fibrotic degeneration of the pericardium and leads to impaired diastolic ventricular filling. It is typically better sitting up and worse when lying down or breathing deeply. Constrictive pericarditis or perhaps better termed pericardial constriction is a type of pericarditis which leads to diastolic dysfunction and potentially symptoms of right heart failure. The diagnosis is established based on clinical findings. The pericardium is the saclike membrane that surrounds the heart. Due to the fact that idiopathic pericarditis comprises the major group, it was divided into two. Pericarditis is the most common form of pericardial disease worldwide and may recur in as many as onethird of patients who present with idiopathic or viral pericarditis.
Constrictive pericarditisa curable diastolic heart failure. Constrictive pericarditis requires surgical treatment and is usually curable, while restrictive cardiomyopathy, short of cardiac transplantation, is treatable only by medical means and often responds unsatisfactorily. In both typical constrictive pericarditis and effusiveconstrictive pericarditis, cardiac filling is impeded by an external force ie, the virtually inelastic parietal andor visceral pericardial tissue, which is thickened, fibrotic, and sometimes calcified. Pericarditis constrictiva is caused by fibrotic degeneration of the pericardium and leads to impaired diastolic ventricular filling. Jul 29, 2014 constrictive pericarditis arises from a stiffening of the pericardium, which prevents complete or satisfactory diastolic filling of the heart. However, after its reserve volume is exceeded, the pericardium markedly stiffens. Clinical presentation is dominated by restricted diastolic. Constrictive pericarditis diagnosis, echocardiography and treatment duration. It is diagnosed in 5% of patients presenting to hospital emergency departments with chest pain in the absence of a myocardial infarction. Pericarditis knowledge for medical students and physicians. The differentiation of restrictive cardiomyopathy and constrictive pericarditis has been a perennial problem in clinical cardiology. However, as a result of the nearly universal findings of a chronically elevated rightsided atrial pressure and passive congestion of the liver, kidneys, and gastrointestinal gi tract, resultant abnormalities may be present see laboratory studies below. The diagnosis of constrictive pericarditis in children remains challenging and often requires a multimodal approach. Esc clinical practice guidelines aim to present all the relevant evidence to help physicians weigh the benefits and risks of a particular diagnostic or therapeutic procedure on pericardial diseases.
Management of penetrating trauma and pericarditis elizabeth thomas, rn, ccrn, cen vicki moran, phd, rn, mph, cne, aphnbc pamela golden, msncs, aprn, ccrnk, tcrn. Pericarditis enfermedades cardiovasculares enfermedades. Acute pericarditis has a number of potential etiologies including infection, acute myocardial infarction, medication use, trauma to the thoracic cavity, and. The main complication of acute pericarditis is pericardial effusion triggering cardiac tamponade. Pericarditis clinical features and management pdf 409kb. Pericarditis is inflammation of the pericardium the fibrous sac surrounding the heart. Constrictive pericarditis is longterm chronic inflammation of the saclike covering of the heart the pericardium with thickening and scarring. The pain may also be felt in the shoulders, neck, or back. Tuberculosis was the most common cause of constrictive pericarditis in the developed world before development of effective drug therapy. Pericarditis pdf reader android bookmarks is an important diagnosis to consider in a patient presenting with chest pain. Treatment with colchicine can reduce recurrence rates. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Pericarditis constrictiva in a 10yearold boy after. Prospective studies of patients after a first bout of acute pericarditis shows that evolution to chronic constrictive pericarditis is very unusual, in fact, after a viral pericarditis, transition to chronic constrictive forms occurs approximately in 1% of cases.
In developed countries clinicians should rule out pericarditis related to a systemic disease as well as neoplastic, tuberculous, and purulent pericarditis. Pericarditis is the most common form of pericardial disease worldwide. Acute pericarditis has a number of potential etiologies including infection, acute myocardial infarction, medication use, trauma to the thoracic cavity, and systemic diseases, such as rheumatoid. Pericarditis constrictiva in a 10yearold boy after in. Pericarditis is an inflammatory disorder of the serous pericardium resulting from a primary insult to the heart or is secondary to a systemic disorder. The condition typically presents with fever, pleuritic chest pain, and a pericardial friction rub heard on auscultation. Symptoms typically include sudden onset of sharp chest pain.
In healthy individuals, the pericardial cavity contains 15. Pericarditis, constrictive constrictive pericarditis picks disease of heart. The etiology of pericarditis may be infectious eg, viral and bacterial or noninfectious eg, systemic inflammatory diseases, cancer, and postcardiac injury syndromes. We present a case of a pericarditis constrictiva in a 10year old boy after influenza a virus infection. Clinicians should be aware of this complication, especially in patients with symptoms of exertional dyspnea and congestive heart failure.
Pericarditis, constrictive constrictive pericarditis picks disease of heart pick disease of heart. Acute pericarditis is an inflammation of the pericardium that is most commonly caused by infection or myocardial infarction, or occurs following cardiac surgery. Constrictive pericarditis is longterm, or chronic, inflammation of the pericardium. They should be essential in everyday clinical decision making. When you have constrictive pericarditis, the inflammation causes the covering of the heart to become thick and rigid. Pericardium the pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a potential space, the pericardial cavity. Constrictive pericarditis radiology reference article.
Tuberculosis was the most common cause of constrictive pericarditis in the developed. Some studies 2 have recently suggested that the etiologic spectrum has changed in the last decades, basically due to an increase in the number of cases secondary to cardiac surgery cs or previous radiotherapy. Appropriate triage and treatment with nsaids may reduce readmission rates for pericarditis. Article pdf available september 2010 with 35 reads. No laboratory data are diagnostic of constrictive pericarditis. Constrictive pericarditis arises from a stiffening of the pericardium, which prevents complete or satisfactory diastolic filling of the heart. Signs and symptoms of constrictive pericarditis are. The hemodynamic alteration in effusiveconstrictive pericarditis is the result of combined effect of fluid accumulation and pericardial constriction and therefore the hemodynamic changes are also intermediate.
Of the many causes, the most frequently encountered include acute idiopathic pericarditis and viral infections. In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause. May, 2015 the hemodynamic alteration in effusiveconstrictive pericarditis is the result of combined effect of fluid accumulation and pericardial constriction and therefore the hemodynamic changes are also intermediate. No single demographic is affected as there are numerous causes of constrictive pericarditis. Pericardial diseases guidelines on the diagnosis and. Constrictive pericarditis is a medical condition characterized by a thickened, fibrotic pericardium, limiting the hearts ability to function normally. Oct 24, 2010 constrictive pericarditis diagnosis, echocardiography and treatment duration. Other symptoms may include fever, weakness, palpitations, and shortness of breath. Pericarditis is an important diagnosis to consider in a patient presenting with chest pain. Tuberculosis is a major cause of pericarditis in developing countries but accounts for less than 5% of cases in developed countries, where idiopathic, presumed viral.
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