Chronic constrictive pericarditis

Abstract

A review of the pathologic physiology, the diagnosis and surgical treatment of constrictive pericarditis, and a report of two cases treated surgically is presented. In concluding this discussion of chronic constrictive pericarditis, we wish to emphasize the cardinal findings in this disease. The heart is normal in size, or only moderately enlarged; it is in a fixed position; little or no evidence of pulsation can be elicited by physical or fluoroscopic examination; the peripheral veins are prominent, particularly the external jugulars; the venous pressure is high and the systolic blood pressure and pulse pressure are low. The liver is enlarged and generally associated with abdominal ascites; there may be fluid in the pleural spaces, and edema of the lower extremities. The signs of passive congestion of the lungs are conspicuous by their absence. It has not been our purpose in writing this article to attempt to present anything new, for this has not been done. Rather it has been our aim, as stated in the beginning, to help stimulate interest in this subject in faraway places where such conditions do exist and where such individuals cannot avail themselves of the diagnostic and surgical skill of the large medical centers. © 1943.