ECHOCARDIOGRAPHIC COMPARISON OF CONSTRICTIVE PERICARDITIS VERSUS RESTRICTIVE CARDIOMYOPATHY

Echo - Constrictive Pericarditis Versus  Restrictive Cardiomyopathy

By Dr Amarja Nagre

Constrictive Pericarditis Vs Restrictive Cardiomyopathy

1)LV & RV= Normal size,thickness  1)LV & RV systolic function decreased

2)RA & LA - Normal    2) RA & LA - Enlarged

3)Septal bounce present   3)No septal bounce

4)Significant respiratory variation in mitral & tricuspid inflow velocities  4)No respiratory variation                      

5)Mitral E’ from lateral annulus is lower than medial annulus  5)E’ decreased both lat & medial annulus   

6)Hepatic vein flow diastolic reversal increases in expiration  6) increases in inspiration                                                                        

7) RVSP <55mmHg   7)RVSP increased >55mmHg

8) PA pressures normal  8)PA pressures increased

9) Pulm vein flow varies with inspiration   9)No variation

10) Brain natriuretic peptide - normal         10) BNP- increased

11) Diastolic BP in all chambers same < 5%    11) > 5%

12) TDI - Annular velocity >8cm/s               12)  < 8cm/s

13) Propogation velocity Vp > 45cm/s          13) < 45cm/s

In Constrictive Pericarditis - Hepatic vein diastolic flow reversal increases with expiration due to ventricular interaction and dissociation of intracardiac and intrathoracic pressures

- by Dr Amarja