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Pericardium
Pericardium


Constrictive pericarditis
Constrictive pericarditis


Pericardium
Pericardium


Definition:

Constrictive pericarditis is long-term (chronic) inflammation of the sac-like covering of the heart (the pericardium) with thickening, scarring, and muscle tightening (contracture ).

See also:



Alternative Names:

Constrictive pericarditis



Causes, incidence, and risk factors:

Constrictive pericarditis is most commonly caused by conditions or events that cause inflammation to develop around the heart, including:

Less common causes include:

Constrictive pericarditis may also develop without apparent cause.

The inflammation causes the covering of the heart to become thick and rigid, making it hard for the heart to stretch properly when it beats. As a result, the heart chambers don't fill up with enough blood. Blood backs up behind the heart, causing heart swelling and other symptoms of heart failure.

The condition is relatively rare in children.



Symptoms:

Symptoms of chronic constrictive pericarditis include:



Signs and tests:

Constrictive pericarditis is very difficult to diagnose. Signs and symptoms are similar to restrictive cardiomyopathy and cardiac tamponade . Your doctor will need to rule out these conditions when making a diagnosis.

A physical exam may show that your neck veins stick out, suggesting increased blood pressure in the area. This is called Kussmaul's sign. The doctor may note weak or distant heart sounds when listening to your chest with a stethoscope.

The physical exam may also reveal liver swelling and fluid in the belly area.

The following tests may be ordered:



Treatment:

The goal of treatment is to improve heart function. The cause must be identified and treated. This may include antibiotics, antituberculosis medications, or other treatments.

Diuretics ("water pills" are commonly prescribed in small doses to help the body remove excess fluid. Analgesics may be needed to control pain.

Decreased activity may be recommended for some patients.

A low-sodium diet may also be recommended.

The definitive treatment is a type of surgery called a pericardiectomy. This involves cutting or removing the scarring and part of the sac-like covering of the heart.



Support Groups:



Expectations (prognosis):

Constrictive pericarditis may be life threatening if untreated.

However, surgery to treat the condition is associated with a relatively high complication rate and is usually reserved for patients who have severe symptoms.



Complications:

Calling your health care provider:

Call your health care provider if you have symptoms of constrictive pericarditis.



Prevention:

Constrictive pericarditis in some cases is not preventable.

However, conditions that can lead to constrictive pericarditis exists should be adequately treated.



References:

LeWinter MM. Pericardial Diseases. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: chap. 70.




Review Date: 5/12/2008
Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100