What are the signs of constrictive pericarditis on CT
pericardial thickening
diffuse or localized(2mm – 3mm equivocal)
signs of impaired diastolic filling of the right ventricle
ie signs of right heart failure including
dilatation of the
RA
IVC and hepatic veins
Coronary Sinus
Azygos vein
Hepatomegaly
What is the role of the CXR and LA in Dx
increase in left atrial because it cannot fill therefore
increase in pulmonary venous pressure
Usually normal size LA
However since LA hmay be only partly covered by pericardium, it may in fact enlar
In our patient there is
no pericardial thickening
minor pericardial calcification
Location 3
CORONARY CALCIFICATION AND PERICARDIAL CALCIFICATION
Location 3
CORONARY CALCIFICATION AND PERICARDIAL CALCIFICATION
There are
focal adhesions near the LAD
Location 3
PERICARDIAL ADHESION
Are There Signs of Constriction?
Consider
Pericardium Thickness Size of the Right Atrium
Location 3
? CONSTRICTION – NORMAL SIZED ATRIAL CHAMBERS The axial image through the region of the AV valves shows normal sized atria. Constriction would be unlikely in the face of a normal sized right atrium. Note the flattened surface of the right atrium Ashley Davidoff MD
? Size of the Coronary Sinus
Location 3
? CONSTRICTION – NORMAL SIZED CORONARY SINUS The axial image through the region of the normal sized coronary sinus. Constriction would be unlikely in the face of a normal sized coronary sinus. Note the flattened surface of the right atrium. Ashley Davidoff MD
? Size of the Azygos Vein and IVC
Location 3
QUESTION CONSTRICTION The axial image is through the region of the normal azygos vein (above) and the normal sized IVC (below). Constrictive pericarditis would be unlikely in the face of a normal sized azygos vein and IVC.
