Constrictive-Effusive Pericarditis(Archived)

Constrictive pericarditis is a disease involving scarring and loss of elasticity of the pericardium surrounding the heart, leading to impaired filling. Effusive-constrictive pericarditis (ECP) is a less common syndrome involving both constriction of the visceral pericardium and an effusion causing a tamponade-like effect on the heart. The etiology is similar to constrictive pericarditis, including cardiac surgery and tuberculosis in the developing world. The symptoms of this syndrome mimic those of heart failure (particularly right-sided heart failure symptoms) and volume overload. This condition is chronic, and treatment is mostly surgical, although, in a subset of patients, treatment of the underlying cause may reverse both the effusion and the constriction. Most cases are idiopathic in terms of etiology. This article reviews this increasingly recognized variant, effusive-constrictive pericarditis, including its diagnosis and management.