A subset of patients with acute constrictive pericarditis can experience spontaneous resolution of constrictive hemodynamics, avoiding the need for pericardiectomy.
OBJECTIVES: This study was designed to elucidate the causes and natural history of transient constrictive pericarditis (CP). BACKGROUND: In some patients with acute CP, the symptoms and constrictive physiologic features resolve with medical therapy alone, a phenomenon that has been labeled "transient constrictive pericarditis." No large studies have examined the causes or natural history of transient CP. METHOD: Review of the Mayo Clinic echocardiogram database identified 212 patients who had echocardiographic findings of CP from 1988 through 1999. Demographic, clinical, and echocardiographic findings were identified in all patients. In 36 of these patients, follow-up echocardiograms showed resolution of the constrictive hemodynamics without pericardiectomy. RESULTS: The average age of the patients was 49 +/- 21 years, and 72% were men. The causes for the CP were diverse, the most common being prior cardiovascular surgery (25%). In a subset of 22 patients who were followed serially during the course of their illness, resolution of the constrictive physiologic features occurred at an average of 8.3 weeks after diagnosis. CONCLUSIONS: A subset of patients with CP experience resolution of the disorder without requiring pericardiectomy.
“Now, a subset of patients who present with constrictive pericarditis undergo spontaneous resolution or response to medical therapy and is referred to as transient constrictive pericarditis. In a review of 212 patients with echo findings of constriction, 17% had follow-up studies showing resolution at an interval ranging from two months to two years. Some degree of effusion was common in these cases.”
Haley et al. (Thu,) studied this question.