DEAR MAYO CLINIC: I recently began experiencing swelling in my legs, feet and hands, as well as fatigue. Testing led to a diagnosis of pericardial constriction. Can you explain what this is and how it's treated? Is there anything I can do to reduce the swelling?
ANSWER: Pericardial constriction is a condition with multiple possible causes. It can be due to underlying medical conditions and may even result from certain medical treatments. Swelling, or edema, is one of the most common symptoms of pericardial constriction because the condition alters how the heart pumps blood to the kidneys and interferes with your kidneys' ability to work properly. Medication often effectively reduces swelling. Rarely, surgery may be needed to remove the pericardium.
The normal pericardium is a thin sac surrounding the heart. Under normal circumstances, it contains a small amount of fluid that helps lubricate the heart as it moves. When the pericardial sac becomes thick and stiff, it constrains the heart, altering how it pumps blood. We call this condition pericardial constriction. Pericardial constriction restricts the heart's motion and makes it harder for the heart to pump blood effectively by limiting how much blood can fill the heart between beats, making the heart less efficient and causing a backup of blood in the veins. When less blood than usual enters the heart, less blood leaves the heart to the rest of the body.
