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In patients with constrictive pericarditis, there are a number of hemodynamic events that occur, and these events can be observed on the physical examination, during cardiac catheterization, and with Doppler echocardiography. When constrictive pericarditis is present, as one inspires and pulls blood through the right heart, the right heart pressures rise rather than fall. This creates the Kussmaul's sign and the ventricular "interdependence" observed at cardiac catheterization.

User Linyun Liu
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Final answer:

Constrictive pericarditis is characterized by thickening of the pericardium, leading to Kussmaul's sign and ventricular interdependence, observable in clinical and diagnostic settings, such as cardiac catheterization.

Step-by-step explanation:

The student's question pertains to the hemodynamics associated with constrictive pericarditis, a condition marked by the thickening of the pericardium, the fibrous sac that surrounds the heart. The increased rigidity of the pericardium restricts the heart's ability to expand when it relaxes during diastole, which in turn leads to a series of hemodynamic changes. Of particular note is Kussmaul's sign, a paradoxical rise in jugular venous pressure on inspiration, and ventricular "interdependence" where the filling of one ventricle affects the filling of the other, a phenomenon observed during cardiac catheterization.

In normal physiology, during inspiration, an influx of blood flows into the right side of the heart, leading to a slight decrease in systemic venous pressure. However, with constrictive pericarditis, this increased volume of inflow cannot be accommodated due to the limited expansion capacity of the constricted pericardial sac, resulting in increased venous pressure, evidenced clinically by Kussmaul's sign. Similarly, during cardiac catheterization, ventricular interdependence is seen as the rigid pericardium encases the heart, making the ventricles interdependent on each other for filling, and this can be observed contrarily—it restricts them during the respiratory cycle, a hallmark feature of constrictive pericarditis.

User Hansang
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