The Hemodynamic Reversal of Delayed-Onset Radiation-Induced Constrictive Pericarditis Obtained by Pericardiectomy

Constrictive pericarditis (CP) is often underdiagnosed, partly because of the lack of established diagnostic criteria. Exaggerated ventricular interdependence during inspiration is a hallmark physiological feature of CP. We herein report the case of a 55-year-old patient with CP who demonstrated a hemodynamic improvement following pericardiectomy. This case is characterized by two features: (1) delayed-onset CP 36 years after undergoin thoracic radiotherapy, which developed without pericardial calcification in contrast to severe aortic calcification, and (2) a postoperative improvement of inspiratory-exaggerated ventricular interdependence, documented by intracardiac pressure tracings. This case provides meaningful insight into the diagnosis and management of radiation-induced CP.