Constrictive Pericarditis: Understanding Its Severity and Treatment Options

Constrictive pericarditis represents the final and most severe stage of acute or subacute pericarditis. It is a progressive chronic condition that often leads to significant health complications, including fatigue, fluid accumulation in the abdomen, peripheral edema, and severe cardiac issues, which can ultimately result in disability or death. However, with timely and complete pericardiectomy, many patients experience favorable outcomes and improved quality of life.

Importance of Early Diagnosis and Surgical Intervention

Early detection and prompt surgical treatment play a crucial role in managing constrictive pericarditis. Patients who undergo partial pericardial resection at an earlier stage can often avoid the development of severe complications such as cardiac cachexia, advanced liver dysfunction, and myocardial atrophy. Once the infection is under control — particularly in cases of tuberculous pericarditis during its quiescent phase — surgery should be performed without delay.

Post-Surgery Medication and Recovery

Following surgery, patients are typically advised to continue medical therapy for up to one year. In cases where tuberculosis is confirmed or suspected, anti-tuberculosis treatment should begin 1 to 4 weeks before the procedure. After complete pericardial removal, patients should maintain prescribed medication for an additional 6 to 12 months to ensure full recovery and prevent recurrence.

Non-Surgical Management for Inoperable Cases

For patients who are not candidates for surgery due to advanced disease or other health limitations, treatment focuses on symptom management. This includes the use of diuretics to reduce fluid buildup, supportive care to improve overall well-being, and, when necessary, drainage of pleural or peritoneal effusions to relieve discomfort and improve organ function.