Difference Between Constrictive Pericarditis and Tamponade


Constrictive pericarditis and tamponade (as well referred to as cardiac tamponade or pericardial tamponade) are both conditions of the pericardium. These two pathologies of the pericardium often present with numerous symptoms of the same nature, making information technology challenging to differentiate or distinguish which one is applicable. There are, however, diagnostic tests and procedures which provide a clearer answer of the condition at manus.


Difference between Constrictive Pericarditis and Tamponade

Definition and Pathophysiology

Constrictive pericarditis is a chronic condition where at that place is thickening of the pericardium over time. This thickening causes the pericardium (the sac roofing the outside of the middle) to gradually lose elasticity and therefore restricts the heart from expanding fully when animate in. The brake experienced by the heart musculus leads to increased diastolic pressures and a quicker increase of ventricular pressures, this is specifically because of the express ability of the ventricular chambers of the heart to relax. Moreover, what would usually be normal decreased intrathoracic pressure level (pressures within the breast) during inspiration (animate in) does not conduct over to the pressures within the heart. The resultant issue is that the pulmonary venous pressure level drops, causing a reduced left-sided stroke volume upon animate in.

Cardiac tamponade is an acute condition where there is an abnormal amount of fluid accumulated in the pericardium (or pericardial sac). The aberrant build-upwards of fluid causes a compressive effect on the middle muscle and is seen as a medical emergency. The compression effect cardiac tamponade has on the eye causes the diastolic filling function of the heart to decrease, which further leads to a compromised cardiac output.

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Potential causes

The causes of constrictive pericarditis are not e’er easy to diagnose. The more common causes however could be a result of heart surgery or trauma to the heart (such as a heart attack), chronic infection such as tuberculosis, or radiation therapy targeted at the chest area. Additional causes (although less common) could be bacterial and viral infections, autoimmune disorder complications, complications as a event of medications, or certain types of cancer.

Cardiac tamponade is commonly caused by trauma or acute conditions. This includes traumatic wounds to the pericardium (such as a gunshot or stab wound), edgeless chest trauma, pericarditis, hyperthyroidism, a complexity of kidney failure, autoimmune diseases, radiation, and certain cancers.

Symptoms

The symptoms associated with constrictive pericarditis and cardiac tamponade are often similar, merely differences practise occur.

The symptoms nigh frequently presented in patients with constrictive pericarditis are:

  • Difficulty breathing that gradually becomes worse
  • Increased fatigue and weakness
  • Swelling in the abdomen with severe swelling in the legs and over the ankles
  • Depression fever
  • Chest pain

The symptoms most often presented in patients suffering cardiac tamponade are:

  • Low blood pressure, feeling faint, dizziness, and/or loss of consciousness
  • Intense and rapid animate
  • Anxiety and feeling restless
  • Trouble breathing or inability to breathe deeply
  • Improvement of discomfort when leaning forward or sitting upward
  • Chest pain that radiates to the dorsum, jaw and shoulders

Diagnosis

Constrictive pericarditis tin can be challenging to diagnose because it presents symptoms that could be confused with other heart weather. Due to this challenge, physicians often primarily diagnosed by ruling out other heart conditions. Patients with constrictive pericarditis often bear witness signs (along with the above-mentioned symptoms), with the primary one being Kussmaul’south sign. Kussmaul’s sign is described as protruding neck veins due to increased claret pressure. Boosted signs are weak middle sounds, fluid in the belly and a bloated liver.

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Tests are also performed to brand a diagnosis. These include:

  • Scans and x-rays (to place whatever claret clots and a thick pericardium)
  • Cardiac catheterization (to take samples directly from the middle tissue and perform measurements)
  • Electrocardiogram (to detect electrical irregularities coming from the heart)

Diagnosing cardiac tamponade is usually associated with Beck’s triad. Brook’s triad consists of 3 master signs which include low blood force per unit area, extended neck veins, and a rapid heartbeat present with muffled centre sounds.

Tests performed to aid in making an accurate diagnosis include:

  • Scans of the chest (to look for accumulated fluid in the pericardium)
  • An angiogram (to see the blood flow within the heart)
  • Electrocardiogram (to discover electrical irregularities coming from the heart)

Handling

In the early onset, constrictive pericarditis can be treated by diuretics to remove backlog water, pain medication, anti-inflammatories, corticosteroids, decreasing activeness, and taking colchicine. When the condition is in a severe state, surgery to cut away the rigid parts of the pericardium (a pericardiectomy) can exist performed.

Cardiac tamponade is usually treated by draining built up fluid from the pericardial sac with the utilize of a needle. If the condition is severe, it may need to be treated by removing clots and fluid surgically and potentially cutting away parts of the pericardium to relieve the pressure.

Table of comparison between constrictive pericarditis and tamponade


Summary of Constrictive Pericarditis vs Tamponade

Constrictive pericarditis and cardiac tamponade ofttimes present similarly on initial exam. However, constrictive pericarditis occurs with a thickened and rigid pericardium, where cardiac tamponade occurs with fluid accumulation inside the pericardial sac. Specialized testing and primary signs distinguish the two conditions for authentic diagnosis and effective treatment.

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FAQ

Is constrictive pericarditis the same every bit tamponade?

No. Constrictive pericarditis presents a thickened and rigid pericardium, where cardiac tamponade presents fluid accumulation inside the pericardial sac.

Can constrictive pericarditis crusade cardiac tamponade?

Constrictive pericarditis is generally a chronic condition, simply a sub-acute occurrence caused past an underlying type of effusion related pericarditis tin cause cardiac tamponade to occur as well.

What is the divergence between pericardial effusion and tamponade?

Pericardial effusion is the term used to draw the accumulated fluid. The accumulated fluid (pericardial effusion) then results in tamponade.

What are the three signs of cardiac tamponade?

Three principal signs include low claret pressure, extended neck veins, and a rapid heartbeat present with muffled middle sounds.

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