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Constrictive Pericarditis and Effusive Constrictive Pericarditis: Is There a Role for Medical Therapy?

Lamis El Harake1, Mohamed Al-Kazaz2, Paul C Cremer2

  • 1Bluhm Cardiovascular Institute, Division of Cardiology, Chicago, Illinois, USA.

Methodist Debakey Cardiovascular Journal
|March 16, 2026
PubMed

Insights

Constrictive pericarditis (CP) involves impaired heart filling due to a stiff pericardium. Early anti-inflammatory treatment can reverse active inflammation and constrictive physiology.

Area of Science:

  • Cardiology
  • Pericardial Diseases

Background:

  • Constrictive pericarditis (CP) is a spectrum of pericardial diseases impairing ventricular filling.
  • Effusive constrictive pericarditis (ECP) and transient constrictive pericarditis involve active inflammation.
  • Causes include idiopathic, post-surgical, autoimmune, or tuberculous origins, potentially progressing to chronic constrictive pericarditis.

Purpose of the Study:

  • To review the diagnosis and management of constrictive pericarditis.
  • To highlight the role of multimodality imaging in assessing inflammation and guiding treatment.
  • To emphasize the benefits of early, combined anti-inflammatory therapy for active pericardial inflammation.

Main Methods:

  • Multimodality imaging: echocardiography, cardiac MRI, cardiac CT.
  • Assessment of pericardial inflammation.
  • Review of anti-inflammatory treatment strategies.

Main Results:

  • Constrictive pericarditis presents a spectrum from transient to chronic forms.
  • Active inflammation is key in ECP and transient forms.
  • Early anti-inflammatory therapy can reverse constrictive pathophysiology.

Conclusions:

  • Multimodality imaging is crucial for diagnosing and managing CP.
  • Early and combined anti-inflammatory therapy is supported for active pericardial inflammation.
  • Treatment aims to reverse constrictive pathophysiology and improve outcomes.

Keywords:
constrictive pericarditiseffusive constrictive pericarditismedical therapymultimodality imagingpericardial inflammation

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