Constrictive pericarditis overview
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Differentiating Constrictive Pericarditis from other Diseases |
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Treatment |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Muhammad Umer Tariq, M.D., Atif Mohammad, M.D.
Overview
Pericardial constriction occurs when a fibrotic, adherent pericardium restricts diastolic filling of the heart. Variants of constrictive pericarditis have been described such as transient, subtle, effusive and chronic, depending on the course of the disease. The disease process typically begins with pericardial inflammation that progresses onto fibrosis. It may occasionally follow an episode of acute pericarditis. There is fibrous scarring of the pericardium and usually fusion of the visceral and parietal pericardium. [1] [2] [3]
Differentiating Pericardial constriction from other Diseases
Constrictive pericarditis must be differentiated from restrictive cardiomyopathy as they are treated very differently. Multi-modality imaging including echocardiography with flow and tissue doppler imaging, cardiac MRI and heart catheterization are used to differentiate between the two conditions that may present with similar clinical signs and symptoms. The finding of ventricular interdependence (respiratory variation of mitral and tricuspid flows) as demonstrated by different imaging modalities is key in differentiating the two syndromes.
References
- ↑ Mehta A, Mehta M, Jain AC. Constrictive pericarditis. Clin Cardiol 1999; 22:334-44.
- ↑ Cameron J, Oesterle SN, Baldwin JC, Hancock EW. The etiologic spectrum of constrictive pericarditis. Am Heart J 1987; 113:354-60.
- ↑ Ling LH, Oh JK, Schaff HV, et al. Constrictive pericarditis in the modern era: evolving clinical spectrum and impact on outcome after pericardiectomy. Circulation 1999; 100:1380-6.