Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1995 Feb;73(2):187–189. doi: 10.1136/hrt.73.2.187

Predictors of constrictive pericarditis after tuberculous pericarditis.

P K Suwan 1, S Potjalongsilp 1
PMCID: PMC483789  PMID: 7696032

Abstract

OBJECTIVE--To identify features which predict the subsequent development of constrictive pericarditis from acute or subacute tuberculous (TB) pericarditis. SETTING--Tertiary referral centre, chest hospital. PATIENTS--The records of 16 consecutive patients in whom acute or subacute TB pericarditis was diagnosed between 1988 and 1990 at a chest hospital were reviewed. These records included a follow up of at least 12 months. RESULTS--During a follow up of 14.2 (12-30) months, 8 patients had constrictive pericarditis diagnosed by cardiac catheterisation or by inspection at the time of operation (group A). There was no evidence of constriction in the other eight patients (group B). There was no significant difference between the two groups in the type or duration of symptoms of TB pericarditis before admission or the volume and characteristics of pericardial fluid obtained at hospital admission. Clinical features of cardiac tamponade on admission correlated closely with the subsequent development of constrictive pericarditis requiring pericardectomy (7/8 v 2/8; P = 0.01), despite the fact that the signs of tamponade resolved completely after pericardiocentesis. CONCLUSION--The findings suggest that cardiac tamponade in the early clinical stage of TB pericarditis is the most predictive factor of subsequent constrictive pericarditis. The degree of fibrosis of pericardium when treatment starts may be the most important determinant of whether or not constriction develops.

Full text

PDF
187

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clifford C. P., Davies G. J., Scott J., Shaunak S., Sarvill J., Schofield J. B. Tuberculous pericarditis with rapid progression to constriction. Prompt diagnosis and treatment are needed. BMJ. 1993 Oct 23;307(6911):1052–1054. doi: 10.1136/bmj.307.6911.1052. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Desai H. N. Tuberculous pericarditis. A review of 100 cases. S Afr Med J. 1979 May 26;55(22):877–880. [PubMed] [Google Scholar]
  3. Fowler N. O. Cardiac tamponade. A clinical or an echocardiographic diagnosis? Circulation. 1993 May;87(5):1738–1741. doi: 10.1161/01.cir.87.5.1738. [DOI] [PubMed] [Google Scholar]
  4. Fowler N. O. Tuberculous pericarditis. JAMA. 1991 Jul 3;266(1):99–103. [PubMed] [Google Scholar]
  5. Gooi H. C., Smith J. M. Tuberculous pericarditis in Birmingham. Thorax. 1978 Feb;33(1):94–96. doi: 10.1136/thx.33.1.94. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. HAGEMAN J. H., D ESOPO N. D., GLENN W. W. TUBERCULOSIS OF THE PERICARDIUM. A LONG-TERM ANALYSIS OF FORTY-FOUR PROVED CASES. N Engl J Med. 1964 Feb 13;270:327–332. doi: 10.1056/NEJM196402132700702. [DOI] [PubMed] [Google Scholar]
  7. Larrieu A. J., Tyers G. F., Williams E. H., Derrick J. R. Recent experience with tuberculous pericarditis. Ann Thorac Surg. 1980 May;29(5):464–468. doi: 10.1016/s0003-4975(10)61681-5. [DOI] [PubMed] [Google Scholar]
  8. Long R., Younes M., Patton N., Hershfield E. Tuberculous pericarditis: long-term outcome in patients who received medical therapy alone. Am Heart J. 1989 May;117(5):1133–1139. doi: 10.1016/0002-8703(89)90873-9. [DOI] [PubMed] [Google Scholar]
  9. Ortbals D. W., Avioli L. V. Tuberculous pericarditis. Arch Intern Med. 1979 Feb;139(2):231–234. [PubMed] [Google Scholar]
  10. Peel A. A. TUBERCULOUS PERICARDITIS. Br Heart J. 1948 Jul;10(3):195–207. doi: 10.1136/hrt.10.3.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Shabetai R., Fowler N. O., Guntheroth W. G. The hemodynamics of cardiac tamponade and constrictive pericarditis. Am J Cardiol. 1970 Nov;26(5):480–489. doi: 10.1016/0002-9149(70)90706-x. [DOI] [PubMed] [Google Scholar]
  12. Spodick D. H. The normal and diseased pericardium: current concepts of pericardial physiology, diagnosis and treatment. J Am Coll Cardiol. 1983 Jan;1(1):240–251. doi: 10.1016/s0735-1097(83)80025-4. [DOI] [PubMed] [Google Scholar]
  13. Strang J. I., Kakaza H. H., Gibson D. G., Allen B. W., Mitchison D. A., Evans D. J., Girling D. J., Nunn A. J., Fox W. Controlled clinical trial of complete open surgical drainage and of prednisolone in treatment of tuberculous pericardial effusion in Transkei. Lancet. 1988 Oct 1;2(8614):759–764. doi: 10.1016/s0140-6736(88)92415-4. [DOI] [PubMed] [Google Scholar]
  14. Wychulis A. R., Connolly D. C., McGoon D. C. Surgical treatment of pericarditis. J Thorac Cardiovasc Surg. 1971 Oct;62(4):608–617. [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES