Pericarditis - constrictive Health Article

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:

• Bacterial pericarditis
• Pericarditis
• Pericarditis after heart attack

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:

• Heart surgery
• Radiation therapy to the chest
• Tuberculosis

Less common causes include:

• Abnormal fluid build-up in the covering of the heart due to bacterial pericarditis or surgical complications
• Mesothelioma

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:

• Difficulty breathing (dyspnea) that develops slowly and gets worse
• Fatigue , excessive tiredness
• Long-term swelling (edema) of the legs and ankles
• Swollen abdomen
• Weakness

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:

• Chest MRI
• Chest CT scan
• Chest x-ray
• Coronary angiography or cardiac catheterization
• ECG
• Echocardiogram