Constrictive pericarditis occurs when the pericardium becomes scarred and stiff, preventing the heart from properly expanding and filling with blood. This causes the heart to work harder to pump enough blood, eventually leading to heart failure if left untreated. Symptoms include shortness of breath, chest pain, fatigue, and swelling. Diagnosis involves tests like echocardiograms, CT scans, and cardiac catheterization. Treatment focuses on managing the underlying cause, using diuretics to reduce fluid, and sometimes pericardiectomy surgery to remove the constricted pericardium. Complications can be life-threatening if not addressed.

1. CONSTRICTIVE PERICARDITIS
PAULINE TEMBO-RN/BSC

3. CONSTRICTIVE PERICARDITIS
Introduction
The normal pericardium is a fibro-elastic
sac surrounding the heart that contains a
thin layer of fluid. That fluid helps cushion
your heart and protect it from injury.
CONSTRICTIVE PERICARDITIS occurs
When larger amounts of fluid accumulate
(pericardial effusion) or when the
pericardium becomes scarred and not
elastic

4. • Under normal circumstances, the pericardium is
flexible and stretchy.
• That means the heart doesn’t have any trouble
expanding to fill up with blood between
heartbeats.
• WhenThe pericardium is stiffer and thicker than
normal , it prevents the heart from expanding as
it should.
• When your heart can’t expand enough to fill up
with blood, it struggles to pump enough to meet
the body’s needs.
• To compensate, it tries to pump blood faster,
which leads to heart failure.

5. • As the heart compensates, the myo-
cardium grows in size as it tries to
pump blood faster to all parts of the
body.
• This leads to high pulse rate, low BP
and arterial fibrillations.
• Unfortunately, this becomes too
much for he heart to handle and it
goes into heart failure.

6. • Tissues in the extremities do not
receive enough blood leading to
ischemia.
• Brain becomes hypoxic and fatigue,
dizziness and fainting starts.

7. Risk factors/causes
The causes of constrictive pericarditis
include:
• Infections: such as viral/bacterial
causes. At times even TB can cause this.
• Post surgical
• Auto-immune conditions
• Radiation complications

8. SYMPTOMS
The symptoms of constrictive pericarditis include:
• Shortness of breath (dyspnea).
• Chest pain.
• Fatigue.
• Dizziness.
• Swelling (especially in the abdomen and lower
legs) from fluid buildup.
• Loss of muscle mass.
• Loss of appetite and feeling full even when
eating very little.

9. DIAGNOSIS
• Testing for tuberculosis.
• Blood tests to confirm or rule out immune
system conditions.
• Echocardiogram which views the heart and its chambers.
• Electrocardiogram is a simple test that can be used to
check the heart's rhythm and electrical activity.
• Chest X-ray.
• Heart computerized tomography (CT) scan.
• Heart magnetic resonance imaging (MRI).
• Left and right heart catheterization:procedure that
involves insertion of a thin flexible tube (catheter) into
the right or left side of the heart, usually through the
groin or arm.

10. TREATMENT
• Treat underlying cause ie treat TB.
• Give anti diuretics such as Lasix to
reduce fluid in the pericardium.
• Pericardiectomy: cutting off part
of the affected pericardium to
make it elastic again.

11. COMPLICATIONS.
• cardiac tamponade- life threatening
emergency where the fluid accumulation is
too much and the internal structures are
squashed together.
• Myocarditis
• Heart failure
• Pnuemonia
• Peripheral neuropathy
• Peripheral gangrene