title: [Work-up and management of constrictive pericarditis: a critical review].
abstract: Constrictive pericarditis is a rare pericardial disorder that causes an impairment of cardiac filling and frequently heart failure. The clinical presentation is non-specific and the differential diagnosis includes myocardial diseases, particularly restrictive cardiomyopathy. Echocardiography has a central role in the initial diagnosis. Some peculiar signs, such as abnormal inspiratory shift of the interventricular septum, increased respiratory variations of transmitral, transtricuspid and hepatic vein flow velocities and the normality of early diastolic relaxation velocity (e') at tissue Doppler, increase the likelihood of the disease. These signs are an expression of increased ventricular interdependence and dissociation between intrathoracic and intracardiac pressures typical of pericardial constriction. For further diagnosis, computed tomography and magnetic resonance are used to identify the presence of pericardial thickening. Invasive cardiac catheterization is indicated in dubious cases and in the assessment of the severity of hemodynamic abnormalities, especially in cases with surgical indication. Pericardiectomy is indicated in symptomatic patients meeting the diagnostic criteria of constrictive pericarditis and is able to improve the prognosis.
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pinamonti
authors.affiliation: Dipartimento Cardiovascolare, Università di Lubjana, Lubjana, Slovenia.
authors.forename: Sara
authors.initials: S
authors.lastname: Habjan
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Luca
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Alberto
authors.initials: A
authors.lastname: Proclemer
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Morea
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Elena
authors.initials: E
authors.lastname: Abate
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Vitrella
authors.affiliation: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Trieste.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
mesh_terms: D006328:Cardiac Catheterization; D002313:Cardiomyopathy, Restrictive / Q000175:diagnosis; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D006801:Humans; D008279:Magnetic Resonance Imaging; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000175:diagnosis* / Q000601:surgery*; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome