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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
Summary
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.
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