Causes of constrictive pericarditis is/are –
**Core Concept**
Constrictive pericarditis is a condition characterized by the scarring and thickening of the pericardium, leading to impaired diastolic filling of the heart. This results in symptoms such as dyspnea, fatigue, and peripheral edema. The condition can be caused by a variety of factors, including infections, autoimmune disorders, and previous cardiac surgery.
**Why the Correct Answer is Right**
The correct answer is tuberculous pericarditis. Tuberculosis (TB) is a common cause of constrictive pericarditis, particularly in regions with high TB prevalence. The infection leads to chronic inflammation of the pericardium, resulting in scarring and fibrosis. This process can cause the pericardium to become calcified and thickened, restricting cardiac filling during diastole. The mechanism involves the activation of inflammatory cells, such as macrophages and T-lymphocytes, which release cytokines and other mediators that promote fibrosis and scarring.
**Why Each Wrong Option is Incorrect**
**Option A:** Idiopathic pericarditis is a condition where the pericarditis is not caused by any known underlying disease. While idiopathic pericarditis can lead to constrictive pericarditis, it is not a specific cause of the condition.
**Option B:** Radiation-induced pericarditis is a rare complication of radiation therapy, but it is not a common cause of constrictive pericarditis. Radiation can cause inflammation and scarring of the pericardium, but this is usually a localized response.
**Option C:** Post-cardiac surgery pericarditis is a known complication of cardiac surgery, but it is not a common cause of constrictive pericarditis. While pericarditis can occur after cardiac surgery, it is usually a self-limiting condition that resolves without long-term consequences.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that constrictive pericarditis can mimic other conditions, such as heart failure and pulmonary embolism. A high index of suspicion and a thorough physical examination, including signs such as Kussmaul's sign and pulsus paradoxus, can help diagnose constrictive pericarditis.
**Correct Answer:** B. Tuberculous pericarditis.