Pericardial constriction with growth failure

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Pericardial Constriction with Growth Failure

Pericardial constriction with growth failure is a medical condition characterized by the restriction of the heart's normal movement due to a thickened, fibrotic pericardium, which can lead to impaired cardiac function and subsequent growth failure, particularly in pediatric patients.

Pathophysiology[edit | edit source]

Pericardial constriction occurs when the pericardium, a double-layered sac surrounding the heart, becomes thickened and fibrotic. This fibrosis restricts the diastolic filling of the heart, leading to reduced cardiac output. The condition can result from various causes, including previous pericarditis, cardiac surgery, or radiation therapy.

In children, the reduced cardiac output can lead to inadequate delivery of oxygen and nutrients to tissues, contributing to growth failure. Growth failure is defined as a significant deviation from the expected growth patterns for age and sex, often measured as a failure to thrive or maintain adequate weight and height.

Clinical Presentation[edit | edit source]

Patients with pericardial constriction may present with symptoms such as:

  • Fatigue
  • Dyspnea (shortness of breath)
  • Peripheral edema
  • Ascites
  • Jugular venous distension

In children, additional signs of growth failure may include:

  • Poor weight gain
  • Delayed developmental milestones
  • Decreased appetite

Diagnosis[edit | edit source]

The diagnosis of pericardial constriction with growth failure involves a combination of clinical evaluation, imaging studies, and hemodynamic assessment. Key diagnostic tools include:

  • Echocardiography: Can reveal thickened pericardium and abnormal ventricular filling patterns.
  • Cardiac MRI: Provides detailed images of the pericardium and can assess the degree of constriction.
  • Cardiac catheterization: Measures pressures within the heart chambers to confirm constrictive physiology.

Treatment[edit | edit source]

The primary treatment for pericardial constriction is surgical pericardiectomy, which involves the removal of the fibrotic pericardium to relieve the constriction. In cases where surgery is not immediately feasible, medical management may include diuretics to manage symptoms of fluid overload.

Nutritional support and monitoring of growth parameters are crucial in managing growth failure. In some cases, supplemental nutrition or feeding interventions may be necessary.

Prognosis[edit | edit source]

The prognosis for patients with pericardial constriction and growth failure depends on the underlying cause and the success of surgical intervention. Early diagnosis and treatment are critical to improving outcomes and promoting normal growth and development in affected children.

Also see[edit | edit source]


Cardiovascular disease A-Z

Most common cardiac diseases

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Contributors: Prab R. Tumpati, MD