Discussion of Constrictive pericarditis
- Causes of constrictive pericarditis:
- Most frequent causes are cardiac surgery and radiation therapy.
- Other causes include infection (viral or tuberculosis), connective-tissue disease, uremia, neoplasm, or idiopathic condition.
- Present with symptoms of heart failure, such as dyspnea, orthopnea, and fatigability, and occasionally may present with hepatomegaly and ascites.
- Clinically, it is difficult to differentiate between constrictive pericarditis and restrictive cardiomyopathy.
- These two entities are characterized by similar clinical manifestations and similar findings at cardiac catheterization and echocardiography.
- In both conditions, ventricular filling is restricted, leading to an increase in diastolic pressure in all four cardiac chambers and to equalization of atrial and ventricular pressure.
- It is important to distinguish between constrictive pericarditis and restrictive cardiomyopathy as with constrictive pericarditis might benefit from pericardial stripping, whereas those with restrictive disease would not.
 Imaging Findings for Constrictive pericarditis
- Normal pericardial thickness is less than 2 mm.
- Pericardial thickness of 4 mm or more indicates abnormal thickening and, when it is accompanied by clinical findings of heart failure, is highly suggestive of constrictive pericarditis.
- CT has a high sensitivity in depicting pericardial calcification, which is associated with constrictive pericarditis.
- Neither pericardial thickening nor calcification is diagnostic of constrictive pericarditis unless the patient also has symptoms of physiologic constriction or restriction.
- Systemic venous dilatation, hepatomegaly, and ascites also are frequently seen.
- Central cardiovascular structures may show a characteristic morphology in constrictive pericarditis.
- Right ventricle tends to have a reduced volume and a narrow tubular configuration.
- In some patients, a sigmoid-shaped ventricular septum or prominent leftward convexity in the septum can be observed.
 See Also
 External Links
 References for Constrictive pericarditis
- Zhen J. Wang, Gautham P. Reddy, Michael B. Gotway, Benjamin M. Yeh, Steven W. Hetts, and Charles B. Higgins. CT and MR Imaging of Pericardial Disease. RadioGraphics 2003 23: 167S-180S.