Etiologic spectrum of constrictive pericarditis in our era and correlations with its clinical presentation

Abstract

Background: Some series have shown changes in the etiologic spectrum of Constrictive Pericarditis (CP). Data is lacking about the chronology of the disease depending of the etiology. Objectives: To describe the clinical presentation of CP emphasizing the timing of symptoms and the etiologic spectrum of a contemporary series of CP. Methods: Retrospective analysis of all cases of operated CP in our institution. Results: From 1978 to 2012, 140 cases of operated CP could be reviewed (99 males (71%), Mean age=54 years (y) (ranging from 19 to 80y)). Mean time of symptoms among all patients was 19.5months (m), ranging from 8 days to 30y. An acute presentation ( 6m) in 55 patients (39%). Table: Time of symptoms per etiology. The etiology of CP was Idiopatic in 76p (54%), post-Acute Idiopatic Pericarditis in 24p (17%), Tuberculous in 15p (11%), Purulent in 10p (7%), post-Cardiac surgery in 5p (3.6%), post-Radiotherapy in 3p (2%), uremia in 2p (1%). Figure 1: Distribution of etiologies in relation with its chronology of symptoms. View this table: Table 1. Etiology and time of symptoms ![Figure][1] Etiologies and timing of symptoms Conclusions: Post-Cardiac surgery and Radiotherapy are still an uncommon cause of CP. The vast majority of cases of chronic CP are idiopatic. The most acute presentation of CP is for patients with purulent CP (less than 1 months of symtoms), followed by uremic CP (1.4m) and Neoplasmic CP (1.7m). [1]: pending:yes