Heart 2001;86:619-623 ( December )

Review

Constrictive pericarditis in the modern era: a diagnostic dilemma

R A Nishimura

Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA

Correspondence to: Dr Nishimura rnishimura@mayo.edu

Accepted 25 July 2001

The first 150 words of the full text of this article appear below.

	Introduction

Constrictive pericarditis is caused by fibrosis and calcification of the pericardium, processes that inhibit diastolic filling of the heart. This condition has posed a diagnostic dilemma since it was first recognised clinically.¹ Although many diagnostic approaches have become available subsequently, the diagnostic challenge remains.² Because surgical intervention can provide complete relief of symptoms in many patients, accurate diagnosis of this disorder is important.³

In the past, it was necessary to differentiate constrictive pericarditis from other causes of right sided heart failure, such as pulmonary embolism, pulmonary hypertension, right ventricular infarction, mitral stenosis, and left ventricular systolic dysfunction. Now, with two dimensional and Doppler echocardiography, these other causes of right sided heart failure can be diagnosed or excluded. Imaging methods such as computed tomography and magnetic resonance scanning can measure pericardial thickness, which is usually increased in patients with constrictive pericarditis.⁴ However, the aetiology of constrictive pericarditis has changed during the . . . [Full text of this article]

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