Causes of Constrictive Pericarditis: Understanding the Primary Triggers

Constrictive pericarditis is a serious condition primarily caused by long-term inflammation and thickening of the pericardium, the thin sac surrounding the heart. The main contributing factors include infections, surgical complications, trauma, and certain diseases that lead to scarring and rigidity of the pericardial tissue.

Common Causes of Constrictive Pericarditis

Tuberculosis Infection

One of the leading causes of constrictive pericarditis is tuberculosis (TB). In some cases, individuals may develop tuberculous pericarditis, which can progress into a chronic inflammatory state. This ongoing inflammation leads to thickening, fibrosis, and adhesion of the pericardium, ultimately impairing the heart's ability to properly contract and relax. Over time, this dysfunction can result in the development of constrictive pericarditis.

Acute Bacterial Infections

Another significant cause is acute bacterial infection, which can lead to purulent pericarditis. If left untreated or unresolved, this condition may evolve into a chronic inflammatory process. As a result, the pericardium becomes thickened and calcified, restricting normal heart function and potentially causing constrictive pericarditis.

Post-Surgical or Traumatic Injury

Heart surgeries or injuries to the chest area can also damage the pericardium, triggering an inflammatory response. In some cases, this damage can lead to chronic inflammation and subsequent scarring, both of which are key contributors to the onset of constrictive pericarditis.

Malignancies

Patients with certain types of heart-related cancers may also develop pericarditis. Tumor growth can infiltrate or irritate the pericardium, leading to inflammation and, in some cases, the development of constrictive pericarditis.

Autoimmune Disorders

Autoimmune conditions, such as systemic lupus erythematosus or rheumatoid arthritis, can cause pericardial effusion — a buildup of fluid around the heart. If this fluid is not properly absorbed, it can lead to persistent inflammation and fibrosis of the pericardium, increasing the risk of constrictive pericarditis.

Symptoms and Treatment Options

Constrictive pericarditis often results in impaired heart function, particularly affecting the heart's ability to relax and fill with blood during diastole. This restriction leads to increased pressure in the venous system and fluid buildup in various parts of the body. Common symptoms include ascites (fluid in the abdomen), leg swelling, and jugular vein distention. Due to the severity of these symptoms, surgical intervention — such as pericardiectomy — may be necessary to remove the affected pericardium and restore normal heart function.