Restrictive and constrictive pericarditis occurs together in
**Core Concept**
Restrictive and constrictive pericarditis are two distinct clinical entities that involve the pericardium, a fibroserous sac surrounding the heart. Restrictive pericarditis refers to inflammation of the pericardium that leads to impaired diastolic filling of the heart, whereas constrictive pericarditis involves fibrosis and thickening of the pericardium, restricting cardiac movement.
**Why the Correct Answer is Right**
The correct answer is **D. Tuberculous pericarditis**. Tuberculosis (TB) can cause both restrictive and constrictive pericarditis due to the body's inflammatory response and subsequent fibrosis. The pericardium becomes inflamed, leading to a restrictive pattern of filling, and eventually, the inflammation resolves, leaving behind a thickened, fibrotic pericardium that restricts cardiac movement, characteristic of constrictive pericarditis.
**Why Each Wrong Option is Incorrect**
* **Option A:** Dressler's syndrome is an autoimmune cause of pericarditis, typically occurring after myocardial infarction, and is more commonly associated with acute pericarditis rather than chronic restrictive or constrictive pericarditis.
* **Option B:** Uremic pericarditis is a complication of chronic kidney disease, often presenting with a restrictive pattern, but it is less likely to progress to constrictive pericarditis.
* **Option C:** Idiopathic pericarditis is a common cause of acute pericarditis, but it is less likely to result in both restrictive and constrictive patterns simultaneously.
**Clinical Pearl / High-Yield Fact**
Tuberculous pericarditis often presents with a triad of fever, chest pain, and a pericardial friction rub. It is essential to consider TB as a possible diagnosis in patients with chronic pericarditis, especially in regions with high TB prevalence.
**Correct Answer: D. Tuberculous pericarditis**