Learn About Constrictive Pericarditis
Constrictive pericarditis is a process in which the sac-like covering of the heart (the pericardium) becomes thickened and scarred.
Related conditions include:
- Bacterial pericarditis
- Pericarditis
- Pericarditis after heart attack
Constrictive pericarditis
Most of the time, constrictive pericarditis occurs due to things that cause inflammation to develop around the heart, such as:
- Heart surgery
- Radiation therapy to the chest
- Tuberculosis
Less common causes include:
- Abnormal fluid buildup in the covering of the heart. This may occur because of infection or as a complication of surgery.
- Mesothelioma
The condition may also develop without a clear cause.
It is rare in children.
When you have constrictive pericarditis, the inflammation causes the covering of the heart to become thick and rigid. This makes it hard for the heart to expand properly when it beats. As a result, the heart chambers don't fill up with enough blood. Blood backs up behind the heart, causing heart swelling and other symptoms of heart failure.
Symptoms of chronic constrictive pericarditis include:
- Difficulty breathing (dyspnea) that develops slowly and gets worse
- Fatigue
- Long-term swelling (edema) of the legs and ankles
- Swollen abdomen
- Weakness
The goal of treatment is to improve heart function. The cause must be identified and treated. Depending on the source of the problem, treatment may include anti-inflammatory agents, antibiotics, medicines for tuberculosis, or other treatments.
Diuretics ("water pills") are often used in small doses to help the body remove excess fluid. Pain medicines may be needed for discomfort.
Some people may need to cut down on their activity. A low-sodium diet may also be recommended.
If other methods do not control the problem, surgery called a pericardiectomy may be needed. This involves cutting or removing the scarring and part of the sac-like covering of the heart.
Cleveland Clinic Main Campus
Allan Klein is a Cardiologist in Cleveland, Ohio. Dr. Klein has been practicing medicine for over 49 years and is rated as an Elite provider by MediFind in the treatment of Constrictive Pericarditis. His top areas of expertise are Constrictive Pericarditis, Pericarditis, Cardiac Tamponade, Heart Failure, and Cardiac Ablation.
Paul Cremer is a Cardiologist in Chicago, Illinois. Dr. Cremer has been practicing medicine for over 19 years and is rated as an Elite provider by MediFind in the treatment of Constrictive Pericarditis. His top areas of expertise are Pericarditis, Constrictive Pericarditis, Sarcoidosis, Aortic Valve Replacement, and Transcatheter Aortic Valve Replacement (TAVR).
Cleveland Clinic Main Campus
Deborah Kwon is a Cardiologist in Cleveland, Ohio. Dr. Kwon has been practicing medicine for over 28 years and is rated as an Elite provider by MediFind in the treatment of Constrictive Pericarditis. Her top areas of expertise are Constrictive Pericarditis, Pericarditis, Mitral Valve Regurgitation, Heart Transplant, and Transcatheter Aortic Valve Replacement (TAVR).
Constrictive pericarditis may be life threatening if untreated.
However, surgery to treat the condition has a high risk for complications. For this reason, it is most often done in people who have severe symptoms.
Complications may include:
- Heart failure
- Pulmonary edema
- Liver and kidney dysfunction
- Scarring of the heart muscle
Contact your provider if you have symptoms of constrictive pericarditis.
In some cases, constrictive pericarditis is not preventable.
However, conditions that can lead to constrictive pericarditis should be properly treated.
Published Date: May 08, 2024
Published By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Hoit BD, Oh JK. Pericardial diseases. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 62.
Jouriles NJ. Pericardial and myocardial disease. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 68.
Lewinter MM, Cremer PC, Klein AL. Pericardial diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 86.