Pathophysiology-constrictive pericarditis

• Adhesion of visceral and parietal pericardial layers → rigid pericardium that limits diastolic filling of ventricles → ↑ systemic venous pressures
• Venous return is limited only after early rapid filling phase; ∴ rapid ↓ in RA pressure with atrial relaxation and opening of tricuspid valve and prominent x and y descents
• Kussmaul sign: JVP does not decrease with inspiration (↑ venous return with inspiration, but negative intrathoracic pressure not transmitted to heart because of rigid pericardium)