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Constrictive Pericarditis

Constrictive Pericarditis is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Constrictive pericarditis, as a cause of right-sided heart failure (HF), often goes undiagnosed. It is often difficult to distinguish from restrictive cardiomyopathies (RCMs). Multiple imaging modalities and invasive hemodynamics are often needed to confirm the diagnosis.


  • Common
    • Idiopathic, viral pericarditis (chronic or recurrent), postcardiotomy, chest irradiation
  • Less common
    • Autoimmune connective tissue disorders, end-stage renal disease, uremia, malignancy (e.g., breast, lung, lymphoma), tuberculosis (most common cause in developing countries)


In the setting of chronic inflammation, the pericardial layers become thickened, scarred, and calcified; the pericardial space is obliterated, and the pericardium becomes noncompliant, which impairs ventricular filling and leads to an equalization of pressures in all four chambers and subsequent HF symptoms.

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Williams, Dominique, et al., editors. "Constrictive Pericarditis." Washington Manual of Medical Therapeutics, 35th ed., Wolters Kluwer Health, 2016. Washington Manual, www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602167/all/Constrictive_Pericarditis.
Constrictive Pericarditis. In: Williams D, Ramgopal R, Gdowski M, et al, eds. Washington Manual of Medical Therapeutics. 35th ed. Wolters Kluwer Health; 2016. https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602167/all/Constrictive_Pericarditis. Accessed May 26, 2019.
Constrictive Pericarditis. (2016). In Williams, D., Ramgopal, R., Gdowski, M., Dretler, A., & Bhat, P. (Eds.), Washington Manual of Medical Therapeutics. Available from https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602167/all/Constrictive_Pericarditis
Constrictive Pericarditis [Internet]. In: Williams D, Ramgopal R, Gdowski M, Dretler A, Bhat P, editors. Washington Manual of Medical Therapeutics. Wolters Kluwer Health; 2016. [cited 2019 May 26]. Available from: https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602167/all/Constrictive_Pericarditis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Constrictive Pericarditis ID - 602167 ED - Williams,Dominique, ED - Ramgopal,Rajeev, ED - Gdowski,Mark, ED - Dretler,Alexandra, ED - Bhat,Pavat, BT - Washington Manual of Medical Therapeutics UR - https://www.unboundmedicine.com/washingtonmanual/view/Washington-Manual-of-Medical-Therapeutics/602167/all/Constrictive_Pericarditis PB - Wolters Kluwer Health ET - 35 DB - Washington Manual DP - Unbound Medicine ER -