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 accesscardiology.mhmedical.com/content.aspx?aid=1202455968 RD 2024/10/12 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.