RT Book, Section
A1 Miranda, William R.
A1 Greason, Kevin L.
A1 Stulak, John M.
A1 Oh, Jae K.
A2 Fuster, Valentin
A2 Narula, Jagat
A2 Vaishnava, Prashant
A2 Leon, Martin B.
A2 Callans, David J.
A2 Rumsfeld, John S.
A2 Poppas, Athena
SR Print(0)
ID 1202455968
T1 Constrictive Pericarditis
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accessmedicine.mhmedical.com/content.aspx?aid=1202455968
RD 2024/04/23
AB Chapter  SummaryThis  chapter  discusses  the  etiology,  presentation,  diagnosis  and  treatment  of  constrictive  pericarditis,  a  potentially  curable  form  of  diastolic  heart  failure  due  to  inflamed,  scarred,  or  even  calcified  pericardium  limiting  diastolic  filling  of  the  heart.  Effusive  or  chronic  constrictive  pericarditis  can  result  from  progression  of  acute  pericarditis  with  pericardial  inflammation  or  pericardial  effusion  (see  Fuster  and  Hurst's  Central  Illustration).  Traditionally,  cardiac  catheterization  has  been  the  gold  standard  for  diagnosing  constrictive  pericarditis,  but  advances  in  cardiac  imaging  have  allowed  diagnostic  hemodynamic  assessment  by  echocardiography,  delineation  of  pericardial  and  cardiac  anatomy  by  computed  tomography,  and  detection  of  pericardial  inflammation  by  cardiac  magnetic  resonance  imaging.  A  subset  of  the  patients  with  constrictive  pericarditis  predominantly  due  to  pericardial  inflammation,  as  seen  in  effusive  or  transient  constrictive  pericarditis,  can  be  managed  medically.  Cardiac  imaging  can  identify  this  subset  of  the  patients.  However,  therapeutic  pericardiectomy  is  the  recommended  treatment  for  symptomatic  patients  with  constrictive  pericarditis.  Surgical  pericardiectomy  can  cure  chronic  constrictive  pericarditis  unless  it  is  mixed  with  myocardial  diseases  from  radiation,  ischemia,  or  fibrosis.  Constriction  can  recur  if  pericardiectomy  is  incomplete.