Occult constrictive pericardial disease. Diagnosis by rapid volume expansion and correction by pericardiectomy.

19 patients with occult constrictive pericardial disease (OCPD) presenting with unexplained fatigue, dyspnea, and chest pain, characterized by normal baseline hemodynamics and normal left ventricular systolic function.

Diagnostic rapid volume infusion (1000 ml normal saline intravenously over 6 to 8 minutes) followed by pericardiectomy (performed in 11 patients).

Symptomatic improvement and hemodynamic response (return to normal or near normal hemodynamics on recatheterization with volume infusion).surrogate