Pericarditis constrictiva

Abstract

Constrictive pericarditis is the final stage of a chronic inflammatory process that causes fibrosis and leads to a loss of elasticity. It is characterized by an impaired diastolic heart filling which leads to a predominant right heart failure with preserved systolic function. Diagnostic goal is aimed to demonstrate characteristic hemodynamics changes secondaries to impaired pericardial compliance, and to show the pericardial involvement. Classic constrictive pericarditis is a slowly progressive disease which usually requires pericardiectomy. Other clinical presentations are: effusive-constrictive pericarditis, with pericardial effusion and concomitant tamponade and constriction, often requiring pericardiectomy; or/and transitory pericarditis, in which a brief acute inflammatory phase is followed by spontaneous remission of the constriction symptoms. Etiology, prior functional class and several comorbidities significantly affect postoperative prognosis.