Abstract
The clinical findings of constrictive pericarditis include an early diastolic pericardial knock, systemic and pulmonary congestion, Kussmaul’s sign, elevated jugular venous pressure, and pulsus paradoxus. The diagnosis of constrictive pericarditis is confirmed by a septal shift and changes in flow velocities as seen on Doppler echocardiography. The pericardial knock is an early diastolic sound caused by rapid cessation of ventricular filling due to a rigid pericardium. Delayed timing and a lower intensity of the pericardial knock are associated with a more favorable prognosis, whereas tricuspid regurgitation and a widened split S2 are associated with an unfavorable prognosis. The definitive treatment for constrictive pericarditis is pericardiectomy.
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1 Electronic Supplementary Material
Video 20.1
Several patients with pericardial knock sounds, as described by Dr. W. Proctor Harvey (File 350 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved) (MP4 1203 kb)
Video 20.2
Pericardial rub: polyserositis, multiple rubs with respiration variation (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC) (MP4 1181 kb)
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Mariorenzi, M.C., Matson, A., Unverferth, K. (2015). Pericardial Constriction. In: Taylor, A. (eds) Learning Cardiac Auscultation. Springer, London. https://doi.org/10.1007/978-1-4471-6738-9_20
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DOI: https://doi.org/10.1007/978-1-4471-6738-9_20
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6737-2
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