Banner image

Pericarditis - constrictive

Constrictive pericarditis

Find

Learn More

Causes

Most of the time, constrictive pericarditis occurs due to things that cause inflammation to develop around the heart, such as:

Less common causes include:

  • Abnormal fluid buildup in the covering of the heart. This may occur because of infection or as a complication of surgery.
  • Mesothelioma

The condition may also develop without a clear cause.

It is rare in children.

Definition

Constrictive pericarditis is long-term (chronic) inflammation of the sac-like covering of the heart (the pericardium) with thickening and scarring.

Related conditions include:

Exams and Tests

Constrictive pericarditis is very hard to diagnose. Signs and symptoms are similar to other conditions such as restrictive cardiomyopathy and cardiac tamponade. Your health care provider will need to rule out these conditions when making a diagnosis.

A physical exam may show that your neck veins stick out. This indicates increased pressure around the heart. When it happens due to constrictive pericarditis that is called Kussmaul's sign. The provider may note weak or distant heart sounds when listening to your chest with a stethoscope. A knocking sound may also be heard.

The physical exam may also reveal liver swelling and fluid in the belly area.

The following tests may be ordered:

Outlook (Prognosis)

Constrictive pericarditis may be life threatening if untreated.

However, surgery to treat the condition has a high risk for complications. For this reason, it is most often done in people who have severe symptoms.

Possible Complications

Complications may include:

Prevention

Constrictive pericarditis in some cases is not preventable.

However, conditions that can lead to constrictive pericarditis should be properly treated.

Symptoms

When you have constrictive pericarditis, the inflammation causes the covering of the heart to become thick and rigid. This makes it hard for the heart to stretch properly when it beats. As a result, the heart chambers don't fill up with enough blood. Blood backs up behind the heart, causing heart swelling and other symptoms of heart failure.

Symptoms of chronic constrictive pericarditis include:

Treatment

The goal of treatment is to improve heart function. The cause must be identified and treated. Depending on the source of the problem, treatment may include antibiotics, medicines for tuberculosis, or other treatments.

Diuretics ("water pills") are often used in small doses to help the body remove excess fluid. Pain medicines may be needed for discomfort.

Some people may need to cut down on their activity. A low-sodium diet may also be recommended.

If other methods DO NOT control the problem, surgery called a pericardiectomy may be needed. This involves cutting or removing the scarring and part of the sac-like covering of the heart.

When to Contact a Medical Professional

Call your provider if you have symptoms of constrictive pericarditis.

Review Date: 5/16/2018
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

ADAM QualityA.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 9-1-1 for all medical emergencies. Links to other sites are provided for information only—they do not constitute endorsements of those other sites. © 1997-2010 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.