10th May 2025

Constrictive Pericarditis

During healing of an acute/chronic pericarditis or resorption of pericardial effusion, granulation tissue  forms on the pericardium. This granulation tissue gradually contracts over time and encases the heart and  may get calcified. This creates pericardial noncompliance (stiff ventricle), leading to increased diastolic  pressures and more rapid rise in ventricular pressures for a given venous return, causing reduced  ventricular filling as compared to a normal pericardium. This results in decreased end diastolic volume  and decreased stroke volume and cardiac output. Approximately 9% of patients with acute pericarditis  develop constrictive physiology. In developed nations, the leading cause of this condition is idiopathic or  post-viral infection with incidence being 40% to 60% of total cases.