What is the most common physical finding in patients diagnosed with constrictive pericarditis?

In constrictive pericarditis, the most common physical finding is a pericardial knock, which is an early diastolic heart sound resulting from the abrupt halt of ventricular filling due to the stiffened pericardium. This finding is characteristic of the disease and is thought to arise when the filling of the ventricles is abruptly limited after the early ventricular filling phase.

While ascites, finger clubbing, and hepatomegaly can be seen in patients with constrictive pericarditis—often as a result of systemic venous congestion and liver congestion—the pericardial knock is distinctive and reflects the unique pathophysiological changes that occur in constrictive pericarditis. This sound provides valuable diagnostic information and underscores the restrictive nature of the cardiac filling, which is pivotal in this condition.

Therefore, recognizing the pericardial knock during auscultation is a critical skill in differentiating constrictive pericarditis from other cardiac conditions.