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Constrictive Pericarditis.

Terrence D Welch1, Jae K Oh2

  • 1Section of Cardiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA; Department of Internal Medicine, Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA.

Cardiology Clinics
|October 14, 2017
PubMed
Summary
This summary is machine-generated.

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Constrictive pericarditis, a stiff pericardium restricting heart expansion, causes diastolic heart failure. Diagnosis involves identifying unique pressure changes and imaging, with surgical pericardiectomy often required for treatment.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Diagnostic Imaging

Background:

  • Constrictive pericarditis is a significant cause of diastolic heart failure.
  • It results from a diseased, inelastic pericardium impeding diastolic ventricular filling.
  • Patients typically exhibit right-sided heart failure symptoms.

Purpose of the Study:

  • To summarize the pathophysiology, diagnosis, and management of constrictive pericarditis.
  • To highlight key diagnostic features and imaging modalities.
  • To underscore the progressive and life-limiting nature of the condition.

Main Methods:

  • Review of clinical presentation and characteristic hemodynamic findings.
  • Emphasis on echocardiography with Doppler imaging.
Keywords:
Cardiac MRConstrictive pericarditisEchocradiographyHeart failure

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  • Inclusion of invasive hemodynamic assessment, cross-sectional imaging, and cardiac MRI for diagnosis and inflammation evaluation.

    • Main Results:

    • Constrictive pericarditis presents with predominant right-sided heart failure.
    • Key diagnostic indicators include dissociation of intrathoracic and intracardiac pressures and enhanced ventricular interaction.
    • Cardiac MRI aids in assessing pericardial inflammation.

    Conclusions:

    • Constrictive pericarditis is a treatable cause of diastolic heart failure.
    • Accurate diagnosis relies on recognizing specific hemodynamic profiles and utilizing advanced imaging.
    • Surgical pericardiectomy is the definitive treatment for most progressive cases.