Constrictive pericardium

The pericardium becomes gradually fibrosed,thickened n inelastic.it acts as a rigid case,encasing d heart.it interferes wid d diastolic relaxation of hrt n hence vehtricular filling.the net result is a reduction in cardiac output n elevation of systemic venous pressure.

Etiology
-TB
-hemopericardium n cardiac surgery.
-mediastinal irradiation
-rheumatoid arthritis
-SLE
-acute pericarditis.

C/f
-weakness,fatigue,wt loss n anorexia.
-pt appears emaciated wid a protuberant abdomen.
-pulse is of low volume n pulsus paradoxus may b present.
-neck veins r engorged.
-kussmauls signs may b positive.this is rise in height of JVP during inspiration.
-Hrt sounds may b muffled
-pericardial knock may b audible
-congestive hepatomegaly.
-ascites

Investigations
-chest radiography:
 Hrt size is normal or reduced.
 Pericardial calcification.
-fluoroscopy shows reduced cardiac pulsations
-echocardiography can confirm peri thickening n calcification.
-ECG show low voltage QRS complex n T wave changes.
-MRI.

Rx
Pericardiectomy is d only definitive Rx.