Which of the following is least likely to cause constrictive pericarditis –
**Core Concept**
Constrictive pericarditis is a condition characterized by the scarring and thickening of the pericardium, leading to a restriction in cardiac filling and a decrease in cardiac output. This condition can be caused by various factors, including infections, inflammation, and trauma.
**Why the Correct Answer is Right**
Constrictive pericarditis is most commonly caused by tuberculous pericarditis, which leads to a chronic inflammatory process that results in fibrosis and calcification of the pericardium. Other causes include post-pericardiotomy syndrome, radiation therapy, and cancer. In contrast, rheumatic heart disease is more likely to cause valvular heart disease rather than constrictive pericarditis.
**Why Each Wrong Option is Incorrect**
**Option A:** Tuberculous pericarditis is a well-known cause of constrictive pericarditis, making this option incorrect.
**Option B:** Post-pericardiotomy syndrome is a recognized cause of constrictive pericarditis, particularly after cardiac surgery.
**Option C:** Cancer can cause constrictive pericarditis by direct invasion or metastasis to the pericardium.
**Clinical Pearl / High-Yield Fact**
Rheumatic heart disease is more likely to cause valvular heart disease, particularly mitral stenosis, rather than constrictive pericarditis.
**Correct Answer:** D. Rheumatic heart disease is least likely to cause constrictive pericarditis.