How is constrictive pericarditis treated?

Written by Liu Ying
Cardiology
Updated on September 06, 2024
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We say constrictive pericarditis refers to a disorder of circulatory disturbances caused by the heart being encased in a densely thickened fibrotic or calcified pericardium, which restricts the filling of the ventricles during diastole. Most patients with constrictive pericarditis will progress to chronic constrictive pericarditis.

At this point, the only effective treatment method is pericardiectomy, but the perioperative risk is very high. A small portion of patients have short-term or reversible pericardial constriction, so for patients who are recently diagnosed and have stable conditions, it is possible to try anti-inflammatory treatment for 2-3 months unless complications such as cardiac cachexia, cardiogenic cirrhosis, or myocardial atrophy occur. For tuberculous pericarditis, anti-tuberculosis treatment is recommended to delay the progression of pericardial constriction, and post-surgery, anti-tuberculosis treatment should continue for one year.

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Written by Liu Yong
Cardiology
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Constrictive pericarditis causes hepatomegaly.

The so-called constrictive pericarditis refers to the presence of fibrotic calcifications and fibrotic hyperplasia in the pericardium, which severely affects the diastolic function of the heart. Once the diastolic function of the heart is compromised, the return flow of venous blood becomes severely obstructed, leading to congestion of the liver. Therefore, once congestion of the liver and spleen occurs, enlargement of the liver can occur, and in severe cases, it can lead to systemic edema, including ascites and similar conditions. Thus, the basic principle behind the enlargement of the liver in constrictive pericarditis is as such. Especially in such cases, patients will experience severe dietary problems, including poor appetite and indigestion, which further lead to low protein levels and malnutrition, exacerbating the enlargement of the liver and edema.

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Written by Chen Tian Hua
Cardiology
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How is acute pericarditis classified?

Acute pericarditis is classified according to the course of the disease, including acute fibrinous pericarditis and acute exudative pericarditis. If classified according to the cause, it can be divided into infectious pericarditis and non-infectious pericarditis. Infectious pericarditis can be caused by viruses, bacteria, tuberculosis, fungi, etc., while non-infectious pericarditis can be seen in tumors, uremia, acute myocardial infarction, aortic dissection, connective tissue disease, trauma, and cardiac surgery, etc. Acute pericarditis is an acute inflammatory disease of the pericardium's parietal layer, and its occurrence requires timely diagnosis. It is also important to further clarify the specific cause of acute pericarditis and actively treat it.

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Written by Tang Li
Cardiology
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What are the infectious causes of pericarditis?

The causes of pericarditis include the following types: first, acute nonspecific; second, tumors; third, autoimmune disorders; fourth, metabolic diseases; fifth, physical factors such as trauma and radiation; sixth, diseases of adjacent organs and tissues, such as acute myocardial infarction, pleurisy, aortic dissection, pulmonary embolism, etc. The infectious causes of acute pericarditis mainly include viruses, bacteria, fungi, parasites, and rickettsiae. Common types of pericarditis include tuberculous pericarditis and purulent pericarditis.

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Written by Liu Ying
Cardiology
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Early symptoms of acute pericarditis

The early symptoms of acute pericarditis are pain, which is located behind the sternum or in the precordial area, typically seen in the fibrin exudative type of inflammation. This pain arises from the friction between the visceral pericardium and the parietal pericardium. The nature of the pain is very sharp and related to respiratory movement, commonly exacerbated by coughing, deep breathing, or swallowing. The pain can radiate to the neck, left shoulder, and left arm. As fluid accumulates in the pericardium and the two layers of the pericardium separate, the pain may decrease or disappear.

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Written by Li Hai Wen
Cardiology
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Symptoms of Acute Pericarditis

Acute pericarditis is not a common disease in daily life. What symptoms or clinical manifestations will appear after someone develops acute pericarditis? The clinical manifestations are mainly reflected in the following aspects: First, patients often experience chest pain and shortness of breath, and this pain often has a certain relationship with breathing. Second, the electrocardiogram often shows changes with ST segment elevation. Third, during a physical examination, doctors can often hear pericardial friction rub, or may feel the sensation of pericardial friction. Based on these symptoms and signs, doctors often make a diagnosis of acute pericarditis.