Approach to treatment of subacute constrictive pericarditis in adults

This figure summarizes our suggested general approach to treating subacute constrictive pericarditis in adult patients. Subacute constrictive pericarditis is generally manifested by chest pain, elevated CRP or ESR, pericardial effusion, and pericardial delayed hyperenhancement on CMR in addition to symptoms and signs of pericardial constriction. The treatment approach outlined above does not apply to patients with chronic constrictive pericarditis, which is manifested by anasarca, atrial fibrillation, hepatic dysfunction, and/or pericardial calcification. Refer to UpToDate topics on constrictive pericarditis for additional detail, including guidance on dosing for the medications in this figure and discussion of the evidence supporting their efficacy. Limited data are available on the duration of drug therapies for constrictive pericarditis. Refer to UpToDate topics also for discussion of treatment of effusive-constrictive pericarditis including pericardiocentesis and treatment of specific causes of this condition (eg, tuberculosis, neoplasm, or systemic rheumatic disease).