Constrictive Pericarditis

Abstract

The pericardium is a fibrous membrane that surrounds the heart and is composed of two components: visceral pericardium and parietal pericardium. Under physiological conditions, it performs important functions, such as lubrication, which minimizes friction between the organ and adjacent structures, limits intrathoracic cardiac motion, aids in filling the cardiac chambers, and participates in the balancing between the right and left ventricles during diastole and systole interactions. Constrictive Pericarditis occurs when the pericardium is thickened, fibrotic and often calcified, significantly reducing its compliance and preventing adequate cardiac filling during diastole. This is a relatively rare condition, with varied causes. The main cause is idiopathic, followed by involvement after heart surgery or radiotherapy, and also - especially in developing countries - of infectious and parasitic etiology, especially tuberculosis. The diagnosis is often challenging, since this disease typically presents with insidious and chronic symptoms, predominantly with systemic venous congestion, mimicking other disorders such as restrictive cardiomyopathy. In the last two decades, the evolution of noninvasive imaging examinations have facilitated the early recognition of Constrictive Pericarditis. Echocardiogram (transthoracic and transesophageal), central and transvalvular pressure Doppler measurements, Magnetic Resonance Imaging and Catheterization are the main exams of choice for the diagnosis. Although drug treatment alleviates the symptoms of heart failure, severe cases may require pericardiotomy.

DOI: 10.56238/homeinternationalanais-079