Pericardial constriction: uncommon patterns.

C onstrictive pericarditis can be defined as a syndrome (or syndromes) resulting from compression of the heart caused by rigid, thickened, and frequently fused pericardial membranes. This syndrome was known about more than three centuries ago, but more recently its clinical spectrum has changed in two ways. Firstly, from the aetiologic point of view, there has been an increase in the number of cases of constrictive pericarditis secondary to chest radiation and cardiac surgery. In particular, cardiac surgery has emerged as an important cause of constrictive pericarditis, representing up to 18–29% of cases in some series, 2 although its prevalence is only 0.2–0.3% following coronary artery bypass grafting or valvar surgery. Secondly, the haemodynamic spectrum has been expanded with other forms of constriction. In this paper we will first comment on the classical syndrome of chronic constrictive pericarditis, and then describe the other less known syndromes of cardiac constriction. Finally, some aetiological considerations will be discussed.