Constrictive pericarditis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Atif Mohammad, M.D.
Overview
Constriction can occur after almost any pericardial process. Historically, the most common etiology was tuberculosis, but in the modern age, this cause now accounts for <2% of cases. In a study of 95 patients undergoing pericardiectomy at Stanford, no cause could be found in 42% of patients. 31% occurred after radiotherapy, particularly following high dose mantle radiation for Hodgkin’s disease. Pericardial constriction occurred a mean of 85 months after radiotherapy, but occurred as early as 1 month and as late as 244 months. It also occurred post-operatively in 11% of cases. Connective tissue disorders accounted for 4%, neoplasm 3%, uremia 2% and sarcoidosis for 1% of cases.
Epidemiology and Demographics
Constriction can occur after almost any pericardial process. Historically, the most common etiology was tuberculosis, but in the modern age, this cause now accounts for <2% of cases. In a study of 95 patients undergoing pericardiectomy at Stanford, no cause could be found in 42% of patients. 31% occurred after radiotherapy, particularly following high dose mantle radiation for Hodgkin’s disease. Pericardial constriction occurred a mean of 85 months after radiotherapy, but occurred as early as 1 month and as late as 244 months. It also occurred post-operatively in 11% of cases. Connective tissue disorders accounted for 4%, neoplasm 3%, uremia 2% and sarcoidosis for 1% of cases.
The likelihood of a constrictive pericarditis diagnosis is less than 10 in 100,000 hospital admissions considering only 9% of acute pericarditis patients develop pericardial constriction. This disease is more prevalent in males with a male-to-female ratio of 3:1. Constrictive pericarditis has been documented in people 8-70 years of age, with a median of 61 years of age.
In a prospective study, 500 patients with acute pericarditis were followed over 8 years. At a median follow-up of 6 years, 9 patients developed constrictive pericarditis among whom 2 patients had viral/idiopathic etiology.[1] Incidence rates of constrictive pericarditis per person years observed were as follows:
| Idiopathic/viral pericarditis | 76 cases per 100,000 person years |
| Connective tissue disease/pericardial injury | 440 cases per 100,000 person years |
| Malignant pericarditis | 633 cases per 100,000 person years |
| Tuberculous pericarditis | 3165 cases per 100,000 person years |
| Purulent pericarditis | 5274 cases per 100,000 person years |
References
- ↑ 1.0 1.1 Imazio M, Brucato A, Maestroni S, Cumetti D, Belli R, Trinchero R; et al. (2011). "Risk of Constrictive Pericarditis After Acute Pericarditis". Circulation. doi:10.1161/CIRCULATIONAHA.111.018580. PMID 21844077.