effusive constrictive pericarditis
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Pathology
- pericarditis involving the visceral layer of the pericardium
- pericardial inflammation resulting in pericardial effusion placed under pressure by the inelastic pericardium
Clinical manifestations
- persistent symptoms & hemodynamic compromise after pericardiocentesis & drainage of pericardial effusion*
- case of persistent elevation of right atrial pressure following pericardiocentesis[1]
- also see constrictive pericardiditis
- low cardiac output
- systemic congestion
- elevated jugular venous pulse
- y descent may be diminished*
- peripheral edema
- hepatomegaly
- pericardial knock is absent*
- pulsus paradoxus may be present*
* distinguishes effusive constrictive pericarditis
Laboratory
- also see constrictive pericarditis
- erythrocyte sedimentation rate may be elevated
- complete blood count (CBC) may show leukocytosis
- adenosine deaminase in pericardial fluid to rule out tuberculosis
Diagnostic procedures
- electrocardiogram may be normal[1]
- pericardiocentesis
Radiology
- echocardiogram
- persistence of elevated right atrial pressure & left ventricular end diastolic pressure after pericardiocentesis & drainage
- cardiac CT
- thickening of the visceral pericardium may be difficult to see on imaging[1]
Management
- also see constrictive pericarditis
- 1st line: glucocorticoids + colchicine[1]