Constrictive pericarditis: Its history and current status
- 1 June 1995
- journal article
- review article
- Published by Wiley in Clinical Cardiology
- Vol. 18 (6), 341-350
- https://doi.org/10.1002/clc.4960180610
Abstract
The diagnosis of constrictive pericarditis remains a challenge because it is often mimicked by restrictive cardiomyopathy. The last few years have seen numerous advances in our ability to differentiate between these two conditions which often have similar physical findings and hemodynamics. This review begins with a brief history of constrictive pericarditis; this is followed by an extensive discussion of newer etiologies, and then the classical clinical history and physical examination findings are described. Radiologic, electrocardiographic, and angiographic findings are discussed. The hemodynamics of constrictive pericarditis are reviewed. Recent results of echocardiographic and echo‐Doppler investigations are presented. Emphasis is placed upon the limitations of M‐mode echocardiography in the diagnosis of constrictive pericarditis. The value of echocardiographic Doppler studies of mitral and tricuspid flow velocity patterns, as well as of those in the pulmonary veins and hepatic veins, is described. Nuclear ventriculograms and angiocardiograms tend to show more rapid ventricular filling in constrictive pericarditis than in restrictive cardiomyopathy. Although only a small number of patients has been studied, these evaluations seem to have merit in separating restrictive cardiomyopathy from constrictive pericarditis. The role of computed tomography scanning and magnetic resonance imaging studies of pericardial thickness in confirming the presence of constrictive pericarditis is discussed. Abnormal pericardial thickening (> 3 mm) confirms the diagnosis of constrictive pericarditis, but only if the characteristic hemodynamic pattern is present. The usefulness of endomyocardial biopsy in recognizing specific varieties of restrictive cardiomyopathy is presented. The topic of occult constrictive pericardial disease is discussed briefly. A discussion of the timing of pericardial resection for the treatment of constrictive pericarditis ends the review.Keywords
This publication has 103 references indexed in Scilit:
- Constrictive pericarditis versus restrictive cardiomyopathy: A reappraisal and update of diagnostic criteriaAmerican Heart Journal, 1991
- Constrictive pericarditis secondary to primary chylopericardiumAmerican Heart Journal, 1985
- Constrictive pericarditis associated with sarcoidosisAmerican Heart Journal, 1984
- Occult constrictive pericardial disease. Diagnosis by rapid volume expansion and correction by pericardiectomy.Cell Metabolism, 1977
- Myocardial Fibrosis in Constrictive PericarditisCirculation, 1973
- Subacute Effusive-Constrictive PericarditisCirculation, 1971
- Constrictive Pericarditis with Particular Reference to EtiologyCell Metabolism, 1962
- Mechanical and Myocardial Factors in Chronic Constrictive PericarditisCell Metabolism, 1953
- Right Auricular and Ventricular Pressure Patterns in Constrictive PericarditisCell Metabolism, 1953
- Pressure Curves from the Right Auricle and the Right Ventricle in Chronic Constrictive PericarditisCell Metabolism, 1951