Constrictive Pericarditis: Signs and Symptoms

00:01 Now, the concept once again, pretty much the continuation of restrictive. When we talk about pericardial effusion.

00:08 The hardest on the once expense, so therefore you expect there to be decrease cardiac output.

00:11 You expect there to be increase accumulation of fluid within the pulmonary veins.

00:14 So therefore, there will be pulmonary edema. I’m walking through this quickly because we have done this so many different times.

00:20 Dyspnea, fatigue, hepatomegaly. Why? Why? The heart is not filling. Back-up. From where? Not the left side. Right? You back-up from the right side.

00:33 You back-up from the right side. Into where? Inferior vena cava.

00:37 Where you going? Liver. What’s gonna happen? Hepatomegaly. Right? Ascites. How was that occurring? Oh maybe there was half a liver damage taking place? And so there many ways in which you would be developing increase accumulation of fluid.

00:51 You have already heart that has decrease cardiac output. And have the liver is not functioning, well.

00:56 Well,maybe end up having poor hypertension. Decrease oncotic pressure.

00:59 Are you with me? So lot of physiology here. Then we have to bring in.

01:02 Remember all of medicine, all of medicine is normal. Pathology is well. Physiology gone array.

01:09 And then, how do you manage your patient? Alright? So you get that down. My goodness.

01:14 You’ve got 90-95 % of medicine down. And then, all you have to do is filling the details. That entrust me.

01:20 That is a eternal journey. Okay? Please don’t feel overwhelmed. You’re here because you need help.

01:26 You’re here so that you can get support. That’s all we’re trying to do.

01:30 Let’s continue. You got this. Feel good about what you’re doing.

01:34 Peripheral edema, sure. Why? Constrictive pericarditis, right side.

01:38 Physical examination, reveal a characteristic pericardial knock. Kussmaul’s sign, is going to be your positive JVD.

01:48 More so with constrictive pericarditis. Not usually seen of cardiac tamponade.

01:53 Because remember cardiac tamponade, whoom. Fluid accumulating pericardial cavity, very, very rapid.

02:01 And so therefore, you’re looking at issues in which hypertension takes place very quickly.

02:05 Hemodynamically unstable that patient. Cardiac Tamponade.

02:09 Give yourself an example such as ventricular wall rupture.