Postoperative constrictive pericarditis-present approach

Cardiac surgery, including coronary artery bypass, has become one of the foremost causes for development of constrictive pericarditis in developed countries. This article reviews the updated understanding of the etiology, physiology, clinical presentation, diagnosis, prognosis and treatment of postoperative pericardial constriction. One of the typical clinical signs suggestive for constrictive pericarditis is development of right side heart failure due to development of a thick and non-elastic pericardium. Postoperative constrictive pericarditis as an early or late complication of heart surgery presents either as an isolated phenomenon, or as a multisystem disorder. Since the clinical findings are often misinterpreted, the patients are treated by physicians from different specialties, and therefore the correct diagnosis may be overlooked. Occasionally, achieving proper diagnosis requires application of invasive cardiological procedures. Early detection of post-surgical pericardial constriction is of great importance for both physicians, hospitalists, cardiac and thoracic surgeons in order to administer proper treatment.