Pericarditis constrictiva: Ätiologie, Diagnostik und Therapie

Constrictive Pericarditis: A Commonly Missed Cause of Treatable Diastolic Heart Failure

Constrictive pericarditis arises as a result of the fibrous thickening of the pericardium due to chronic inflammatory changes from various injuries. Increased pulmonary and systemic venous pressures manifest clinical features of left and right heart failure. Idiopathic or post-viral pericarditis is the most common cause followed by postpericardiotomy, radiation-induced causes. Right-sided heart failure symptoms predominate over left-sided heart failure symptoms due to the equalization of pressures. No single diagnostic test can provide a definitive diagnosis or evidence of constrictive pericarditis. Medical management is difficult for constrictive pericarditis. The treatment of choice for constrictive pericarditis is pericardiectomy.

Constrictive pericarditis in a young patient with very thick pericardium initially diagnosed as cirrhosis

Constrictive pericarditis (CP) is a disease of pericardium that restricts filling of the heart. Patients with CP generally present to hospitals with exercise-induced dyspnea, pretibial edema and abdominal ascites, and it is sometimes mistakenly diagnosed as liver or renal disease. Pericardial thickening, which is defined as more than 4 mm in diameter, is observed in nearly 80% of patients. In the present paper, we describe a case of CP with a pericardial thickness of 12 mm that was initially diagnosed as cirrhosis.