The Washington Manual of Medical Therapeutics helps you diagnose and treat hundreds of medical conditions. Consult clinical recommendations from a resource that has been trusted on the wards for 50+ years. Explore these free sample topics:
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Constrictive pericarditis, as a cause of right-sided heart failure (HF), often goes undiagnosed. It is often difficult to distinguish from restrictive cardiomyopathies (RCMs). Multiple imaging modalities and invasive hemodynamics are often needed to confirm the diagnosis.
- Idiopathic, viral pericarditis (chronic or recurrent), postcardiotomy, chest irradiation
- Less common
- Autoimmune connective tissue disorders, end-stage renal disease, uremia, malignancy (e.g., breast, lung, lymphoma), tuberculosis (most common cause in developing countries)
In the setting of chronic inflammation, the pericardial layers become thickened, scarred, and calcified; the pericardial space is obliterated, and the pericardium becomes noncompliant, which impairs ventricular filling and leads to an equalization of pressures in all four chambers and subsequent HF symptoms.