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Advances in the differentiation of constrictive pericarditis and restrictive cardiomyopathy

D R Zwas1, I Gotsman, D Admon

  • 1Heart Failure Center, Heart Institute, Hadassah University Hospital, P.O.B 12000, 91120, Jerusalem, Israel.

Herz
|September 1, 2012
PubMed

Insights

Constrictive pericarditis diagnosis requires considering right heart failure. Imaging, clinical data, and sometimes invasive studies differentiate it from restrictive cardiomyopathy.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging

Background:

  • Unexplained right heart failure necessitates considering constrictive pericarditis.
  • Differentiating constrictive pericarditis from restrictive cardiomyopathy is clinically significant.

Purpose of the Study:

  • To review diagnostic approaches for constrictive pericarditis.
  • To highlight the role of cardiac imaging in diagnosis.

Main Methods:

  • Review of anatomic and physiologic findings on echocardiography, CT, and cardiac MRI.
  • Discussion of clinical presentation, history, and invasive hemodynamic studies.
  • Consideration of biopsy for identifying treatable causes.

Main Results:

  • Cardiac imaging (echocardiography, CT, MRI) often determines the diagnosis.
  • Hemodynamic studies can clarify diagnostic uncertainty.
  • Biopsy may reveal treatable etiologies.

Conclusions:

  • Constrictive pericarditis should be suspected in right heart failure.
  • A multimodal diagnostic strategy including imaging and potentially invasive methods is crucial.
  • Identifying treatable causes through biopsy is important.

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