Constrictive pericarditis secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hafiz M. Ahmed, M.D.[2]
Overview
Secondary prevention of constrictive pericarditis focuses on identifying potentially reversible inflammatory constriction, treating the underlying cause, and preventing progression to chronic irreversible constrictive physiology when possible.
Secondary Prevention
- Cardiac magnetic resonance imaging may help identify active pericardial inflammation in patients with constrictive physiology.
- Inflammatory constrictive pericarditis should be treated first with anti-inflammatory therapy, which may resolve constrictive physiology or reduce inflammation before surgery if pericardiectomy remains necessary.
- Inflammatory constrictive pericarditis may improve spontaneously or with anti-inflammatory therapy given for approximately 3 to 6 months.
- In tuberculous constrictive pericarditis, antituberculous therapy may resolve constrictive pathophysiology, and corticosteroids may enhance clinical improvement in selected patients.
- Noninflammatory constrictive pericarditis and inflammatory constrictive pericarditis that fails anti-inflammatory therapy should be evaluated for radical surgical pericardiectomy.[1]
References
- ↑ Wang TKM, Klein AL, Cremer PC, Imazio M, Kohnstamm S, Luis SA, Mardigyan V, Mukherjee M, Ordovas K, Vakamudi S, Wohlford GF. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Diagnosis and Management of Pericarditis: A Report of the American College of Cardiology Solution Set Oversight Committee. Journal of the American College of Cardiology. 2025;86(25):2691-2719. https://doi.org/10.1016/j.jacc.2025.05.023.