Constrictive pericarditis and its main histologic feature?

Constrictive pericarditis and its main histologic feature?

• A. Pericardial scarring and thickening with fibrous adhesions; leads to diastolic dysfunction
• B. Purulent pericarditis with neutrophils
• C. Pericardial effusion without scarring
• D. Calcified pericardial cyst

Answer: (A)

Constrictive pericarditis is defined by a stiff, noncompliant pericardium that restricts the heart's ability to fill during diastole. The main histologic feature reflecting this is dense fibrous thickening of the pericardium with scar formation, often accompanied by fibrous adhesions between the visceral and parietal layers and sometimes calcification. This scarred, inelastic pericardium prevents proper ventricular filling, producing diastolic dysfunction and signs of systemic venous congestion. Purulent pericarditis would show neutrophilic inflammation and purulent material, not primarily a thickened fibrotic shell. A pericardial effusion without scarring indicates fluid accumulation without the constrictive structural change. A calcified pericardial cyst is a discrete lesion, not the diffuse fibrous constriction seen in constrictive pericarditis.

Constrictive pericarditis is defined by a stiff, noncompliant pericardium that restricts the heart's ability to fill during diastole. The main histologic feature reflecting this is dense fibrous thickening of the pericardium with scar formation, often accompanied by fibrous adhesions between the visceral and parietal layers and sometimes calcification. This scarred, inelastic pericardium prevents proper ventricular filling, producing diastolic dysfunction and signs of systemic venous congestion.

Purulent pericarditis would show neutrophilic inflammation and purulent material, not primarily a thickened fibrotic shell. A pericardial effusion without scarring indicates fluid accumulation without the constrictive structural change. A calcified pericardial cyst is a discrete lesion, not the diffuse fibrous constriction seen in constrictive pericarditis.