A constrictive pericarditis is a type of pericarditis which leads to diastolic dysfunction and potentially symptoms of right heart failure.
No single demographic is affected as there are numerous causes of constrictive pericarditis. Causes include :
- tuberculosis : most common cause
- viral infection(s)
- pyogenic infection(s)
- rheumatic fever : rare 4
- previous cardiac surgery
- chronic renal failure
Clinical presentation is dominated by restricted diastolic ventricular filling resulting in an increase in diastolic pressure in all four cardiac chambers. Patients typically present with symptoms of both left and right sided heart failure including:
- easy fatigability
Characterized by fibrous or calcific constrictive thickening of the pericardium, which prevents normal diastolic filling of the heart. It may follow any type of pericardial effusion and may develop within a variable time frame ranging from two or three months to a number of years.
Plain film / chest radiograph
In approximately 50% of cases there is visible pericardial calcification on CXRs.
- the pericardium is often thickened to more than 4 mm
- may show septal flattening on cine MRI
Treatment and prognosis
It is potentially curable by a pericardiectomy.
Clinically, it is difficult to differentiate between constrictive pericarditis and restrictive cardiomyopathy. It is important to distinguish between constrictive pericarditis and restrictive cardiomyopathy as the former benefit from pericardial stripping.
This article is in need of some more references!
You can make a difference to Radiopaedia.org by adding some relevant ones.
- 1. Weissleder R, Wittenberg J, M.D. MG et-al. Primer of Diagnostic Imaging, Expert Consult- Online and Print. Mosby. (2011) ISBN:0323065384. Read it at Google Books - Find it at Amazon
- 2. Belloni E, De cobelli F, Esposito A et-al. MRI of cardiomyopathy. AJR Am J Roentgenol. 2008;191 (6): 1702-10. doi:10.2214/AJR.07.3997 - Pubmed citation
- 3. Anand SS, Saini VK, Wahi PL. CONSTRICTIVE PERICARDITIS. Dis Chest. 1965;47 (3): 291-5. doi:10.1378/chest.47.3.291 - Pubmed citation
- 4. Lindinger, A.; Schmaltz, A. A.; Hoffmann, W. Constrictive pericarditis due to acute rheumatic fever European Heart Journal. 8 (suppl J): 241. doi:10.1093/eurheartj/8.suppl_J.241