Chronic Constrictive Pericarditis: Epidemiological, Diagnostic and Therapeutic Aspects in a Low-income Country

Objective: To describe the epidemiological, diagnostic and therapeutic aspects of chronic constrictive pericarditis (CCP) in a multicentre hospital setting in sub-Saharan Africa. Methods: This was a retrospective descriptive study conducted over a 12-year period that included patients with a confirmed diagnosis of CCP. Data on clinical, paraclinical, aetiological, therapeutic and evolutionary characteristics were collected from medical records. The analysis focused on demographic characteristics, medical history, clinical signs, additional tests, aetiologies, management strategies and hospital outcomes. Results: A total of 20 patients were included in the study. The mean age was 46.5 ± 19.1 years, with a male predominance (sex ratio 1.5). All patients were symptomatic, with dyspnoea present in all cases (NYHA III 66%, NYHA IV 34%). The past medical history included tuberculosis (40%), acute pericarditis (35%), and breast neoplasia (10%). Echocardiography revealed pericardial thickening in all cases, with calcifications present in 90% of patients. These abnormalities were confirmed in 5 patients who underwent chest CT scans. The mean time to diagnosis was 5.3 ± 1 months. The most common aetiology was tuberculosis (55%), followed by idiopathic (35%) and neoplastic (10%) forms. All patients received symptomatic treatment, with only one undergoing pericardectomy. Intrahospital mortality was 5%. Conclusion: CCP is a rare but treatable cause of heart failure, primarily associated with tuberculosis in our setting. Improving management and prognosis requires wider access to specialist investigations and surgery. This study highlights once again that tuberculosis remains a major public health issue with high morbidity and mortality in low-income countries.