Epidemiology
- Effusion is present in 28% of all pericardial disease cases (including constrictive pericarditis and acute pericarditis)
Physiology
- Mechanism: elevated systemic capillary and PCWP pressures with transudation of fluid into pleural space
- Development of “Cardiac Cirrhosis”: hepatic vein pressures are typically higher in constrictive pericarditis than those in right-sided congestive heart failure -> increasing probablity of developing hepatic necrosis (and ultimately cardiac cirrhosis)
Diagnosis
- Echocardiogram: necessary
- Swan: necessary
- Cardiac Catheterization:
Clinical Manifestations
Cardiac Manifestations
- General Features
- Elevated Jugular Venous Pressure
- Kussmaul’s Sign (see Kussmaul’s Sign, [[Kussmauls Sign]]): rise in the jugular venous pressure on inspiration
- Pericardial Calcification on CXR
- Pericardial Knock
- Features Characteristic of Fluid Overload-Type Presentation
- Anasarca
- Peripheral/Lower Extremity Edema (see Lower Extremity Edema, [[Lower Extremity Edema]])
- Features Characteristic of Low Cardiac Output-Type Presentation
- Exertional Dyspnea (see Dyspnea, [[Dyspnea]])
- Fatigue (see XXX)
Gastrointestinal Manifestations
- “Cardiac Cirrhosis” (see Congestive Hepatopathy, [[Congestive Hepatopathy]])
- Congestive Hepatopathy (Passive Hepatic Congestion) (see Congestive Hepatopathy, [[Congestive Hepatopathy]])
- Absence of Jaundice/Hyperbiliruinemia: often absent in cases due to constrictive pericarditis (for unclear reasons)
- Ascites
- Hepatomegaly
- Peripheral Edema
- Pulsatile Liver
Pulmonary Manfestations
- Pleural Effusion (See Pleural Effusion-Transudate, [[Pleural Effusion-Transudate]])
- Pleural effusion is present in 28-60% of cases
- Can be left, right, or bilateral
- xxx
Treatment
- xxx
References
- xxx