Constrictive pericarditis is a disease characterized by progressive pericardial fibrosis. If left untreated it can lead to progressive heart failure and can be severely disabling. Medical management with non-steroidal anti-inflammatory drugs in combination with colchicine is promising in the acute phase of the disease but for more chronic cases pericardiectomy offers the best chance for hemodyn...

Historical Aspects The reduction in pulse volume during inspiration was first described by Lomer in 1669 in constrictive pericarditis1. A similar finding was described by Floyer and later by William in 1850 in bronchial asthma1. Adolf Kussmaul (Freiberg, Germany) coined the term “pulsus paradoxus” in 1873 in three patients with constrictive pericarditis. The “paradox” was: (1) the discrepancy b...

Purulent pericarditis remains a life-threatening pathology. There is no consensus on its medicosurgical management. Nevertheless, total pericardiectomy eradicates focus of infection and provides a better outcome than simple pericardial drainage. Because of high morbidity, intrapericardial fibrinolysis has been considered as a less invasive approach for prevention of persistent and constrictive ...