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Role of Echocardiography in Diagnosis of Constrictive Pericarditis: a Practical Summary

  • Echocardiography (T Schindler, Section Editor)
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Abstract

Purpose of Review

Constrictive pericarditis (CP) is an uncommon diagnosis in the modern day. Clinically, CP and restrictive cardiomyopathy can present in a similar fashion; however, differentiating the two entities is imperative since CP is potentially curable by pericardiectomy. In this manuscript, we aim to summarize echocardiographic characteristics of CP with a focus on parameters discriminating CP from restrictive cardiomyopathy (RCM).

Recent Findings

Classically, respiration-related interventricular septal shift and variations in mitral inflow and mitral annular velocities have been used to distinguish CP from RCM. Moreover, newer sophisticated echocardiography techniques including myocardial strain imaging by two-dimensional speckle tracking echocardiography (2D STE) have revolutionized our understanding of the myocardial mechanics in CP and RCM. Reduced circumferential strain in CP as well as reduced longitudinal strain in RCM has been shown to provide high sensitivity and specificity to differentiate the two clinical imitators.

Summary

Echocardiography remains an important modality for diagnosing constrictive pericarditis. Advances in echocardiographic techniques have further improved the diagnostic ability of this imaging modality in diagnosing constriction and differentiating it from other clinically similar entities.

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Abbreviations

CP:

Constrictive pericarditis

IVC:

Inferior vena cava

IVS:

Inter ventricular septum

LA:

Left atrium

LV:

Left ventricular

PV:

Pulmonary valve

PW:

Pulsed- wave

RA:

Right atrial

RV:

Right ventricular

SVC:

Superior vena cava

TDI:

Tissue Doppler imaging

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

2D:

Two-dimensional

2D STE:

Two-dimensional speckle tracking echocardiography

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Stony Brook University Medical Center, Health Sciences Center T16-080, Stony Brook, NY, 11794, USA

    Neda Dianati-Maleki & Smadar Kort

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  1. Neda Dianati-Maleki
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  2. Smadar Kort
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Correspondence to Smadar Kort.

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Dianati-Maleki, N., Kort, S. Role of Echocardiography in Diagnosis of Constrictive Pericarditis: a Practical Summary. Curr Cardiovasc Imaging Rep 10, 42 (2017). https://doi.org/10.1007/s12410-017-9439-8

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