Pericardial constriction

Abstract

The clinical findings of constrictive pericarditis include an early diastolic pericardial knock, systemic and pulmonary congestion, Kussmaul’s sign, elevated jugular venous pressure, and pulsus paradoxus. The diagnosis of constrictive pericarditis is confirmed by a septal shift and changes in flow velocities as seen on Doppler echocardiography. The pericardial knock is an early diastolic sound caused by rapid cessation of ventricular filling due to a rigid pericardium. Delayed timing and a lower intensity of the pericardial knock are associated with a more favorable prognosis, whereas tricuspid regurgitation and a widened split S2 are associated with an unfavorable prognosis. The definitive treatment for constrictive pericarditis is pericardiectomy.