Constrictive Pericarditis: multimodal imaging

Constrictive pericarditis is a clinical condition that demonstrates signs and symptoms of diastolic heart failure, caused by an abnormally enlarged and rigid pericardium, and a subsequent decrease in ventricular filling due to lower distensibility. Among the causes of constrictive pericarditis are the inflammation due to infection (viral, mycobacterial, or fungal), connective tissue diseases, or cardiac surgery. Two-dimensional (2-D) transthoracic ultrasound and in the Doppler mode is the main diagnostic tool in the evaluation of heart failure. It can also identify constrictive pericarditis in the majority of patients by means of real-time movement techniques and haemodynamic findings. Likewise, computed tomography and magnetic resonance provide additional information for the diagnosis and management of constrictive pericarditis, and are particularly useful when the cardiac ultrasound findings are inconclusive. The haemodynamic evaluation by cardiac catheterisation can occasionally provide additional information in cases in which the non-invasive images show suggestive of inconclusive findings of constrictive pericarditis.