Aetiology

• Any cause of pericarditis (particularly TB)
• Persisting inflammation = immune cells inititate fibrosis of serous pericardium, contstricting the heart preventing proper filling of chambers (constrictive pericarditis) leading to:
  • reduced stroke volume
  • Increased HR

PC

• dyspnoea
• right sided heart failure - elevated JVP, ascites, oedema, hepatomegaly

On examination:

• JVP shows prominent x and y descent
• pericardial knock - loud S3
• Kussmauls sign is positive (the paradoxical increase in JVP that occurs during inspiration)

Investigations

• CXR: pericardial calcification

Key differences between constrictive pericarditis and cardiac tamponade:

TAMpaX - Tamponade only has a X decent

Management

• May require pericardiectomy (removal of pericardium)