Acute vs. Constrictive Pericarditis
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| Acute Pericarditis - onset, duration: | • Onset occurs within two weeks of the “offending” condition
• May last up to 6 weeks
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| Acute Pericarditis - Etiology | • Acute injury
• Fibrin, white blood cells, and endothelial cells are released and cover pericardium
• Friction between layers causing irritation and inflammation
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| Acute Pericarditis - symptoms | • Chest pain
• Chills
• Fever
• Sweating
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| Acute Pericarditis - complications | • Pericardial Effusion
• Tamponade
• Constrictive pericarditis
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| Constrictive Pericarditis - description | • A thickened, fibrotic and adherent pericardium restricting diastolic filling of the heart
• Most start with acute pericarditis/PE
• *Pericardium undergoes fibrotic thickening, calcification and fusion (like a scab or scar)
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| Constrictive Pericarditis - etiology | • Idiopathic (most common cause US)
• TB (most common in underdeveloped countries)
• Chronic renal failure
• Lupus
• Post cardiac surgery or pericardiotomy
• Post PE
• Tumor involvement
• Recurrent pericarditis
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| Constrictive Pericarditis - symptoms | • JVD (hallmark finding)
• Pericardial knock
• Minimal PE present
• “Square root sign” – equalization of diastolic pressures in 4 chambers
• Weakness/fatigue
• Weight loss/muscle wasting
• Abdominal distension
• Hepatomegaly
• Dyspnea
• Ankle ed
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| Constrictive Pericarditis - complications | • Decreased cardiac output
• Congestive heart failure
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