Constrictive Pericarditis

Constrictive pericarditis is a condition where the protective sac around the heart, called the pericardium, becomes thickened and stiff. This stiffness prevents the heart from expanding properly when it fills with blood, leading to problems with blood flow. The main body system involved is the cardiovascular system, specifically the heart and its surrounding tissues. People with this condition often experience symptoms like swelling in the legs, difficulty breathing, and fatigue due to poor heart function. The heart's inability to fill normally can cause fluid buildup in the body and reduced blood circulation. This condition can develop after infections, heart surgery, or radiation therapy. Overall, it significantly affects how well the heart can pump blood to the rest of the body.

Constrictive pericarditis is a chronic inflammatory process resulting in a thickened, fibrotic, and often calcified pericardium that restricts diastolic filling of the heart. The core pathology involves loss of pericardial elasticity, leading to impaired ventricular expansion and equalization of diastolic pressures in all cardiac chambers. It is commonly caused by prior pericarditis due to infections (e.g., Mycobacterium tuberculosis), cardiac surgery, radiation therapy, or idiopathic fibrosis. The major clinical significance lies in its presentation with signs of right heart failure, including elevated jugular venous pressure, peripheral edema, and ascites, despite preserved systolic function. Hemodynamically, it mimics restrictive cardiomyopathy but is distinguished by pericardial thickening and calcification. Early recognition is critical as it may be reversible with pericardiectomy.