Constrictive Pericarditis: Symptoms, Causes, Treatment
التهاب التامور المضيّق
Constrictive pericarditis limits heart expansion and filling because of changes in its surrounding sac. Constriction may be transient with active inflammation or permanent from scarring.
What is Constrictive Pericarditis?
Symptoms resemble other causes of heart failure, including restrictive heart-muscle disease. Correct diagnosis helps determine whether medication or surgery is appropriate.
Related reading: Pericarditis and its symptoms.
Symptoms
Breathlessness, fatigue, leg swelling and abdominal fluid accumulation can develop gradually and reduce activity tolerance.
Causes
Previous pericarditis, heart surgery, radiation or infection such as tuberculosis may contribute. Sometimes no clear cause is identified.
Risk factors
Prior pericarditis, surgery or chest radiation increases suspicion. These factors do not establish that every episode of swelling is caused by constriction.
Diagnosis
Echocardiography, CT or MRI evaluates filling, the pericardium and inflammation. Some uncertain cases require invasive heart-pressure measurements.
Treatment
Selected inflammatory cases receive medical treatment and surveillance; cautious diuretics relieve congestion. Permanent or unresponsive constriction may require pericardiectomy at an experienced center.
Complications
Chronic congestion, exercise limitation and liver or kidney dysfunction may occur. Surgical risks and benefits depend on cause, stage and overall health.
Prevention
Not all cases are preventable. Follow treatment of the underlying cause and recommended follow-up after surgery or radiation; do not independently adjust diuretics.
When to see a doctor
Severe breathlessness, chest pain or fainting requires emergency care. Rapidly worsening swelling or reduced urine needs urgent review.