Constrictive Pericarditis and Restrictive Cardiomyopathy

Abstract

Constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM) are often discussed together, despite being different disease processes. Both diseases lead to diastolic dysfunction physiologically, but mechanisms are different; in CP, pathology lies in pericardium, while in RCM myocardium is the issue. Given the spectrum of disease and the various clinical manifestations of pericardial constriction and cardiac restriction, initial history and physical examination along with hemodynamic considerations and newer non-invasive imaging criteria now lead the way in making the diagnosis. However, when the findings from non-invasive imaging are inconclusive, invasive cardiac catheterization is still the gold standard for diagnosis. Using all available data in distinguishing between the two processes is important, as the treatment for each is very different.