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Advances in the differentiation of constrictive pericarditis and restrictive cardiomyopathy

Fortschritte in der Unterscheidung zwischen konstriktiver Perikarditis und restriktiver Kardiomyopathie

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Abstract

The diagnosis of constrictive pericarditis should be considered in any patient with unexplained right heart failure. The differentiation between constrictive pericarditis and restrictive cardiomyopathy is based on a combination of clinical presentation, history and imaging, and on occasion, on the basis of invasive hemodynamic studies or biopsy. Pertinent anatomic and physiologic findings on cardiac imaging modalities including echocardiography, computed tomography and cardiac magnetic resonance imaging are reviewed, and in many cases the diagnosis can be determined on the basis of imaging. Hemodynamic studies may clarify the diagnosis, and biopsy may find treatable causes of disease.

Zusammenfassung

Bei jedem Patienten mit einer Rechtsherzinsuffizienz ungeklärter Genese sollte eine konstriktive Perikarditis als Diagnose in Betracht gezogen werden. Die Abgrenzung der konstriktiven Perikarditis von der restriktiven Kardiomyopathie basiert auf einer Kombination aus Klinik, Anamnese und Bildgebung sowie in manchen Fällen auf invasiven hämodynamischen Untersuchungen oder Biopsien. Im Beitrag werden relevante anatomische und physiologische Befunde der kardialen Bildgebung, z. B. der Echokardiographie, Computertomographie und kardialen Magnetresonanztomographie, erörtert. In vielen Fällen kann die Diagnose auf Grundlage der Bildgebung gesichert werden. Auch hämodynamische Untersuchungen dienen der Diagnosesicherung, mithilfe der Biopsie lassen sich therapierbare Krankheitsursachen aufdecken.

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Acknowledgments

We would like to thank Dr. Ronen Durst for kindly providing figures for this review.

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Heart Failure Center, Heart Institute, Hadassah University Hospital, P.O.B 12000, 91120, Jerusalem, Israel

    D.R. Zwas, I. Gotsman, D. Admon & A. Keren MD

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  1. D.R. Zwas
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  2. I. Gotsman
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  3. D. Admon
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  4. A. Keren MD
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Correspondence to A. Keren MD.

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Zwas, D., Gotsman, I., Admon, D. et al. Advances in the differentiation of constrictive pericarditis and restrictive cardiomyopathy. Herz 37, 664–674 (2012). https://doi.org/10.1007/s00059-012-3663-4

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  • DOI: https://doi.org/10.1007/s00059-012-3663-4

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