Clinical profile of patients with chronic constrictive pericarditis about a Tunisian serie

Abstract

Chronic constrictive pericarditis (CCP) is a rare entity responsible of diastolic heart failure. The true prevalence is yet to be defined. Most often, CCP remains a real challenge owing to the diagnosis and the etiology which are not easy to establish in almost cases. To describe clinical and para-clinical characteristics of patients with CCP. A retrospective study during from 2010 to 2019 including 9 patients hospitalized for CCP in our cardiology department. The mean age was 41.5 years. The majority were men ( n = 7). Dyspnea was the most common sign. Peripheral signs were dominated by signs of right heart failure. Cardiac ultrasonography showed pericardial thickening and Doppler adiastolic signs in 90% of cases. Only one patient had a normal doppler echocardiography. Thoracic CT was performed in 8 patients and cardiac MRI was performed in 3 patients. They made it possible to highlight the calcifications and the measurement of the pericardial thickening. Cardiac catheterization performed in 4 patients showed the aspect of Dip plateau. Tuberculosis was retained in three patients. The post-radiation origin was retained in two patients, one case of pericardial amyloidosis and one case of fibrosing mediastinitis.Two cases were idiopathic. Four patients benefited from pericardectomy with good results in the medium and long term. Two patients presented in an advanced cardiac failure and died in few days. One patient refused surgery and died after one month. One patient died of neoplasia. Chronic constrictive pericarditis remains a rare condition ith a dark prognosis. Doppler echocardiography with CT, cardiac MRI and especially cardiac catheterization have facilitated the diagnosis. The imaging also allows etiological orientation. Medical treatment options are limited.