Constrictive pericarditis

Posted by admin on August 29th, 2008 at 11:32pm

Constrictive pericarditis is defined as a chronic inflammation of the pericardial sac i.e. a sac like lining of the heart called as the pericardium making it thickened, scarring, and with the tightening of the muscle. Relatively this condition is rarely seen in children.

Commonly constructive pericarditis is caused due to another condition which is responsible for development of inflammation around the heart, such as cardiac surgery, Tuberculosis and Radiation therapy to the chest.

The conditions that less commonly causes the constructive pericarditis are:

Accumulation of abnormal amount of fluid within the lining of the heart may be due to the pericarditis caused because of bacterial infection or surgical complications. Mesothelioma is also considered as a cause for it. Many times it is also found that there is no any apparent cause for the development of the constrictive pericarditis.

The inflammation makes the lining of the heart more thickened and very rigid that produces difficulty for the heart to expand enough whenever it beats. And due to this, the chambers of the heart do not fill properly with enough amount blood. Thus it causes the swelling of the heart and also the other symptoms of heart failure.

Common features of constrictive pericarditis

There are various symptoms of chronic constrictive pericarditis. Patient may feel dyspnea i.e. difficulty in breathing, this symptom develops slowly and then gets worse. Many times patient feel fatigue and excessive tiredness, edema i.e. swelling on legs and on ankle joint for long time, even the abdomen is seen swollen. Weakness is also quite common.

Diagnosing and treating constrictive pericarditis

It is very difficult to make out the diagnosis of Constrictive pericarditis. It may be misdiagnosed with restrictive cardiomyopathy and cardiac tamponade because of the similar signs and symptoms. The physician may need to look for these conditions while making a diagnosis. After the physical check-up of the patient, it may show that veins of the neck stick out; this suggests raised blood pressure in that area. This condition is called as Kussmaul’s sign. While listening to the chest with the help of stethoscope, the physician notices the weak or distant type of heart sounds. While going through physical exam it may also find that there is swelling of the liver and accumulation of fluid in the abdominal region.

Along with the physical exam some more tests are to be done, those are MRI-chest, CT scan chest, ECG, X-ray chest and either cardiac catheterization or coronary angiography.

To improve the cardiac function is the main aim of the treatment. First the cause must be identified and then must be treated. For this, treatment may need certain antibiotics, drugs those are tuberculosis or other types of treatments. Such as, diuretics are used in small doses in order to remove the excess fluid from the body.

To get rid of the pain analgesics are prescribed. Some of the patients must be told to decrease their activity. Even low-sodium diet recommended. The exact treatment is a surgery called pericardiectomy. In this surgery there is removing or cutting the scarring and the affected part of the pericardium.

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