Constrictive pericarditis is a curable diastolic heart failure condition, but it is frequently unrecognized. Advances in multi-modality imaging and a better understanding of constrictive hemodynamics have improved detection of constrictive pericarditis.
Once recognized, a subset of the patients can be managed medically although most constrictive patients require complete pericardiectomy. Most patients recover fully after pericardiectomy, but some patients with superimposed myocardial disease may not.
• Characteristic diagnostic features of constriction is dissociation between the intracardiac and the intrathoracic pressure with respiration that can be easily detected by echocardiography and cardiac MRI as well as by cardiac catheterization.
• If constriction is predominantly caused by inflamed pericardium, NSAID or steroid can cure the condition.
• Prognosis of constrictive pericarditis is influenced by concomitant myocardial and valvular diseases.
• Successful pericardiectomy requires removal of the pericardium as much as possible. Otherwise, a patient may not recover from constrictive pericarditis.