*This disorder results when the healing of an acute fibrinous or serofibrinous pericarditis or the resorption of a chronic pericardial effusion is followed by obliteration of the pericardial cavity with the formation of granulation tissue
→The latter gradually contracts and forms a firm scar, encasing the heart and interfering with filling of the ventricles.
*Clinical findings:
Exertional dyspnea, weakness, fatigue, weight gain, increased abdominal girth, abdominal discomfort, and edema are common.
A paradoxical pulse
Congestive hepatomegaly, ascites, the distended neck veins
The apical pulse is reduced. The heart sounds may be distant.
*The ECG: low voltage of the QRS complexes and diffuse flattening or inversion of the T waves
-The chest roentgenogram: a normal or slightly enlarged heart; pericardial thickening.
-The echocardiogram: the presence of a thickened pericardium
*Differential diagnosis:
-Cor pulmonale: advanced parenchymal pulmonary disease is usually obvious and venous pressure falls during inspiration
-Tricuspid stenosis: a characteristic murmur, no paradoxical pulse
-Restrictive cardiomyopathy: a well-defined apex beat, cardiac enlargement
*Treatment:
Pericardial resection
Dietary sodium restriction and diuretics are useful during preoperative preparation
Tension pneumothorax (28/02/2011) Dyspnea on Exertion in a 46-Year-Old Man CME (09/02/2011) When Is a Lung Abscess Like Popcorn? (09/01/2011) Pneumothorax (17/12/2010) Overview of pulmonary embolism (17/12/2010) TRANSUDATIVE PLEURAL EFFUSION (17/12/2010) Lung transplantation (17/12/2010) Emphysema (17/12/2010)
