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Constrictive Pericarditis: Causes

by Carlo Raj, MD
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    00:01 Let’s go into a little bit further ideology of constrictive.

    00:04 Importantly, frequently tested, constrictive pericard prior irradiation to chest. And that’s important.

    00:10 So if you’re patient and even to this stem with cancer, in chemotherapy and such a radio therapy, excuse me.

    00:17 Then you might introduce enough damage in advertently, in which now you end up developing constrictive pericarditis; Hodgkin’s disease, breast cancer.

    00:28 Now, if its tuberculosis, almost any disease that causes acute pericarditis, stop there.

    00:37 Acute pericarditis, what does that mean? Rapid accumulation of fluid within the pericardial cavity may result in pericarditis. Granted.

    00:44 With that increased inflammatory, you have now developed or introduced damaged over a period of time. What made then happen? Well, enough fibrosis in calcification, we have now gone in to constrictive pericarditis.

    00:55 So any, any cause of acute pericarditis for example, let me give you another analogy.

    01:02 Who is this patient? Hey doc, I have pain. Where? In my stomach area. Okay.

    01:08 Tell me about this pain. Hmm, everyone’s is my feel like the pain is ah… I feel it in the back is well. Really? What’s your number one differential? What organism has been infecting? Pancreas? Sure, epigastric pain radiating to the back.

    01:21 And the alcohol, and you find that your lipase is elevated. Less likely, acute pancreatitis.

    01:27 But if you have recurrent, recurrent, recurrent, recurrent acute pancreatitis, you call this, is a diagnosis recurrence of your acute pancreatitis.

    01:36 No, you would then call it chronic pancreatitis. Same concept.

    01:39 When you have acute pericarditis and you have enough damage over and over and over and over again, Doesn’t that lead into chronicity? Well you don’t call this chronic type of pericarditis.

    01:50 You would then call this constrictive. Because of enough fibrotic and calcification taking place.

    01:56 Other infections involve: radiation we just talk about, breast cancer and Hodgkin’s or Huge neoplasia, Rheumatoid arthritis and trauma.

    02:03 So any, any cause resulting in an acute pericarditis may result in constrictive.


    About the Lecture

    The lecture Constrictive Pericarditis: Causes by Carlo Raj, MD is from the course Pericardial Disease.


    Included Quiz Questions

    1. All of the above
    2. Coxsackie virus infection
    3. Rheumatoid arthritis
    4. Prior irradiation to the chest
    5. Neoplasm
    1. It is a reversible constriction of the heart
    2. It is the potential outcome of many recurrent episodes of pericarditis
    3. The pericardium appears white on radiography
    4. It causes a dysfunction in the diastolic relaxation of the heart
    5. It leads to decreased cardiac output
    1. Vasoconstriction of pulmonary arteries
    2. Restricted filling of the heart
    3. Equalized diastolic pressures
    4. Shifting of the interventricular septum with breathing
    5. Unexpandable casing surrounding the heart

    Author of lecture Constrictive Pericarditis: Causes

     Carlo Raj, MD

    Carlo Raj, MD


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