title: Transient Constrictive Pericarditis: Current Diagnostic and Therapeutic Strategies.
abstract: Transient constrictive pericarditis is increasingly recognized as a distinct sub-type of constrictive pericarditis. The underlying pathophysiology typically relates to impaired pericardial distensibility, associated with acute or sub-acute inflammation, rather than the fibrosis or calcification often seen in chronic pericardial constriction. Accordingly, patients may present clinically with concomitant features of pericarditis and constrictive physiology. Non-invasive multimodality imaging is advocated for diagnosis of transient constrictive pericarditis. Echocardiography remains the mainstay for initial evaluation of the dynamic features of constriction. However, cardiac magnetic resonance imaging can provide complimentary functional information, with the addition of dedicated sequences to assess for active pericardial edema and inflammation. Although transient pericardial constriction can spontaneously resolve, institution of anti-inflammatory therapy may hasten resolution or even prevent progression to chronic pericardial constriction. Non-steroidal anti-inflammatory agents remain the initial treatment of choice, with subsequent consideration of colchicine, steroids, and other immune-modulating agents in more refractory cases.
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Desk J1-5, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
authors.forename: James
authors.initials: J
authors.lastname: Gentry
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Desk J1-5, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
authors.forename: Allan L
authors.initials: AL
authors.lastname: Klein
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Desk J1-5, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. jellisc@ccf.org.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Jellis
mesh_terms: D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D004452:Echocardiography; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D019028:Magnetic Resonance Imaging, Cine; D010494:Pericarditis, Constrictive / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D010496:Pericardium / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology
chemical_list: D000893:Anti-Inflammatory Agents
keywords: Cardiac magnetic resonance imaging; Echocardiogram; Inflammation; Pericarditis; Transient pericardial constriction