Constrictive pericarditis

Constrictive pericarditis is a pericardial syndrome where the pericardium becomes relatively rigid and inelastic, may be thickened and calcified or not, and impairs mid to late diastolic filling. Constrictive pericarditis is the final pathway of several different diseases or causes, usually starting from pericarditis and pericardial effusion, and progressing towards pericardial fibrosis and calcification. Constrictive pericarditis is commonly the final evolution of any type of pericarditis and pericardial effusion. The risk of developing such evolution is especially related to the aetiology. The risk of progression is especially related to the aetiology: low (<1%) in viral and idiopathic pericarditis, intermediate (2–5%) in immune-mediated pericarditis and neoplastic pericardial diseases, and high (20–30%) in bacterial pericarditis, especially purulent pericarditis. It is important to recognize transient (subacute) constrictive pericarditis early on in the process versus calcific chronic constrictive pericarditis.