What is Chronic Constrictive Pericarditis?

Pericarditis is a human heart disorder in which the lining of the heart becomes inflamed. This lining is called the pericardium. The pericardium performs many important roles that aid to the normal functioning of the heart. It holds the human heart in its appropriate position in the chest; it protects the heart from infection by separating it from the other internal organs and prevents the heart from overfilling with blood. It also lubricates the heart with the pericardial fluid to reduce the friction produced because of the contraction and relaxation of the heart muscles.

What are the Types of Pericarditis?

Pericarditis can be either acute or chronic in nature. Acute pericarditis develops suddenly and is typically resolved within three weeks with rest and therapy. The patients typically complain of a sharp pain the chest that resembles the pain experienced during a heart attack. This pain is pronounced when the patient inhales and improves when the patient leans forward while sitting up. The patients also experience low blood pressure, a high temperature (fever) and heart palpitations. In Chronic pericarditis, the symptoms develop gradually over a period of many months. It also takes longer to treat the condition and more often than not, the patient develops further complications.

What is Chronic Constrictive Pericarditis?

If chronic pericarditis is left untreated over a prolonged period or it is not properly treated, it may lead to other serious heart disorders. One of those complications is chronic constrictive pericarditis. In the normal heart, the pericardium is a flexible in nature but does not stretch very much. One of its key functions is to make sure the heart does not fill up with blood too quickly. When the pericardium continues to experience inflammation over a long period, it gradually starts developing scar tissue. This makes it lose its flexibility and becomes more rigid. Thus, now the heart is not able to fill at the earlier capacity and this keeps worsening over time. This results in a development of a chronic constrictive pressure on the heart muscles and this condition is termed chronic constrictive pericarditis.

What are the Clinical Symptoms Of Chronic Constrictive Pericarditis?

Typically, patients complain of breathing difficulty that becomes worse over a period. This is accompanied by general symptoms of fatigue, mild fever and some degree of chest pain. The patients also tend to have swelling in their legs, liver and abdomen.

How is Diagnosis Of Chronic Constrictive Pericarditis Carried Out?

This condition is not easy to diagnose as there are other medical conditions that may also apply a similar constrictive pressure on the heart such as restrictive cardiomyopathy or cardiac tamponade. A key differentiator from other heart conditions is the presence of the Kussmaul’s sign. Here the veins in the neck of the patients appear to bulge due to the high blood pressure. Apart from the physical exam, a correct diagnosis is usually achieved by ruling out these other heart conditions using tests like electrocardiogram, echocardiogram, CT (computed tomography) scan and MRI (Magnetic resonance imaging).

What are The Therapy Options Available To Treat Chronic Constrictive Pericarditis?

The goal of the treatment is to reduce the pressure on the heart. This can be done by either removing the excess fluid using diuretics or decreasing the intake of table salt; reducing the inflammation of the pericardium by using non-steroidal anti-inflammatory drugs, corticosteroids or colchicine and taking pain killers to combat the chest pain. It is also advisable to decrease your activity level to give your heart time to recover.

What is the Prognosis Of Chronic Constrictive Pericarditis?

This condition needs immediate medical attention and prompt treatment. If the condition is not diagnosed and treated at the right stage, this can be life threatening as the patient may develop heart failure. Most people who are diagnosed and treated at an early stage go on to lead long healthy lives.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:March 29, 2018

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