Clinical meaning
Constrictive pericarditis results from chronic pericardial inflammation leading to fibrosis and calcification that encases the heart in a rigid shell. The non-compliant pericardium limits diastolic filling, equalizing pressures across all four chambers. Venous return is preserved in early diastole but abruptly halted when the ventricle hits the rigid pericardial constraint.
Diagnosis & workup
Diagnostics & workup: - Order echocardiogram with Doppler (septal bounce, respirophasic variation) - Order cardiac CT for pericardial thickening and calcification - Order cardiac MRI for pericardial inflammation assessment - Order right heart catheterization showing equalization of diastolic pressures - Order BNP (typically normal or low, unlike restrictive CM) - Order CBC and inflammatory markers
Risk factors: - Prior cardiac surgery - Prior radiation therapy - Tuberculosis (common globally) - Idiopathic/viral pericarditis - Chronic renal failure - Connective tissue diseases - Prior purulent pericarditis