Common causes of constrictive pericarditis include prior heart surgery, a history of radiation therapy, infections such as tuberculosis, chest injury, and other possible factors.

Constrictive pericarditis is a rare condition that involves changes to a part of the heart called the pericardium.

The pericardium is a fluid-filled sac surrounding the heart. This structure helps hold the heart in place and reduces friction as the heart beats. In constrictive pericarditis, the pericardium thickens. This creates added pressure that can have a negative effect on the heart.

This article will explore the possible causes of constrictive pericarditis, as well as its prevention, diagnosis, symptoms, treatment, and outlook.

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Constrictive pericarditis may occur for several reasons. These range from prior heart conditions to infections such as tuberculosis.

Prior heart surgery

In rare cases, individuals who have undergone heart surgery may develop constrictive pericarditis. It typically develops as a later complication of heart surgery during long-term follow-up.

Although constrictive pericarditis is a potential heart surgery complication, it is extremely rare. Researchers estimate that it affects only 0.2 to 0.3% of people recovering from open-heart surgery.

A history of radiation therapy

Radiation therapy involves the use of radiation to destroy certain cells in the body. This treatment is a common option for individuals with cancer. However, it can also lead to heart conditions such as constrictive pericarditis when administered to the chest near the area of the heart.

One possible side effect of radiation is fibrosis, which is the thickening and scarring of bodily tissues. Fibrosis in heart tissue increases the risk of heart diseases such as coronary artery disease, cardiomyopathy, and pericardial disease.

Individuals who undergo radiation therapy may develop constrictive pericarditis years or even decades later. A 2017 study examined a case in which this condition developed 22 years after radiation therapy.

Certain infections

Viral, fungal, or bacterial infections may also lead to inflammation in the heart and may be a risk factor for constrictive pericarditis.

Tuberculosis (TB) is the most common cause of this heart condition in developing areas of the world. However, TB is not prevalent in all areas. In areas with little incidence of TB, other infections cause up to 60% of constrictive pericarditis cases, such as post-viral infection.

These other infections may include viral infections such as COVID-19 or the flu.

Inflammatory conditions and injury

There are a number of other potential causes of constrictive pericarditis. Some inflammatory diseases can cause this condition. One example is rheumatoid arthritis.

Individuals may also develop constrictive pericarditis after a chest injury. This may occur due to trauma, such as during a car accident.

Other conditions

Other potential causes include:

Constrictive pericarditis can develop for a variety of reasons. To learn more about causes and risk factors, a person may consider speaking with a doctor.

In some cases, it is possible to prevent constrictive pericarditis. In other cases, this condition may develop without a clear cause. This can make it difficult or impossible to prevent.

One way to help prevent constrictive pericarditis is to treat conditions that may cause it. Some of these include heart damage, infections, or inflammatory diseases, as discussed above. Promptly treating these conditions may reduce the risk of developing constrictive pericarditis later.

Individuals with a history of pericarditis also have a higher risk of developing constrictive pericarditis. For these individuals, it is crucial to receive prompt treatment. They may also need to check in with their doctor regularly for ongoing monitoring.

A diagnosis of constrictive pericarditis may include a medical history and a physical exam, which allows doctors to evaluate symptoms and listen for any abnormal sounds in the heart with a stethoscope.

If they suspect constrictive pericarditis, they may then order certain imaging tests. These may include an echocardiogram or electrocardiogram. Both of these tests can help diagnose constrictive pericarditis and look for complications, such as pericardial effusion, or fluid around the heart.

Some individuals with constrictive pericarditis may not experience any symptoms. If they do, these symptoms may include:

Anyone experiencing these or other symptoms may wish to speak with a doctor. Only a medical professional can determine the cause of these symptoms and provide a diagnosis.

The only treatment that can completely treat constrictive pericarditis is pericardiectomy. This is a surgical procedure involving the removal of the pericardium. However, this surgery is not appropriate for everyone. Doctors typically do not recommend pericardiectomy for individuals with:

  • a mild form of constrictive pericarditis
  • only a few symptoms
  • additional health conditions

Beyond surgery, there are less invasive treatment options that may be more suitable for some people. These may include medications such as:

Doctors may recommend one of these medications. They may also prescribe a combination of different drugs. To learn more about individual treatment options, it is best to consult a medical professional.

As constrictive pericarditis is a rare heart condition in the United States, information about long-term health outcomes remains limited.

With early diagnosis and prompt treatment, many individuals recover and return to daily living. Without proper diagnosis and treatment, mortality rates may exceed 90%.

Certain treatments may also affect an individual’s health outlook. For example, the 10-year survival rate for people who undergo pericardiectomy is around 50%. Although this procedure may be lifesaving, it may lead to long-term health risks in certain cases.

Below are some frequently asked questions about the causes of pericarditis.

What is the most common systemic cause of pericarditis?

Worldwide, the leading cause of pericarditis is infection. Pericarditis may occur because of fungal, viral, or bacterial infections. It may also develop as a result of heart inflammation due to surgery or a heart attack.

What are the underlying causes of pericarditis?

The underlying cause of pericarditis is inflammation. Pericarditis involves inflammation of a fluid-filled sac called the pericardium. This swelling can increase pressure on the heart and may negatively affect heart function.

What are four causes that are most commonly associated with acute pericarditis?

Infections, heart attacks, heart surgery, and inflammatory disease can all cause acute pericarditis. Other causes may include kidney failure, radiation therapy, and chest injuries.

Constrictive pericarditis is a rare heart condition. This condition involves swelling of the pericardium, a structure that helps protect and support the heart.

In the developing world, the leading cause of constrictive pericarditis is tuberculosis. In parts of the world where tuberculosis is uncommon, causes may include viral or bacterial infections. Some people may also develop this heart condition after radiation therapy or heart surgery.

Some individuals with constrictive pericarditis may be asymptomatic, whereas others experience difficulty breathing, fatigue, and weight gain.

Treating constrictive pericarditis may include surgery to remove the pericardium. Certain medications can also help manage symptoms in less severe cases.