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CLINICAL RESEARCH: PERCARDIAL DISEASE

Transient constrictive pericarditis: causes and natural history

John H. Haley, MD, FACC^*,*, A. Jamil Tajik, MD, FACC^*, Gordon K. Danielson, MD, FACC, Hartzell V. Schaff, MD, FACC, Sharon L. Mulvagh, MD, FACC^* and Jae K. Oh, MD, FACC^*

^* Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA

Manuscript received October 29, 2002; revised manuscript received August 20, 2003, accepted August 26, 2003.

^* Reprint requests and correspondence: Dr. John H. Haley, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
haley.john{at}mayo.edu

OBJECTIVES: This study was designed to elucidate the causes and natural history of transient constrictive pericarditis (CP).

BACKGROUND: In some patients with acute CP, the symptoms and constrictive physiologic features resolve with medical therapy alone, a phenomenon that has been labeled "transient constrictive pericarditis." No large studies have examined the causes or natural history of transient CP.

METHODS: Review of the Mayo Clinic echocardiogram database identified 212 patients who had echocardiographic findings of CP from 1988 through 1999. Demographic, clinical, and echocardiographic findings were identified in all patients. In 36 of these patients, follow-up echocardiograms showed resolution of the constrictive hemodynamics without pericardiectomy.

RESULTS: The average age of the patients was 49 ± 21 years, and 72% were men. The causes for the CP were diverse, the most common being prior cardiovascular surgery (25%). In a subset of 22 patients who were followed serially during the course of their illness, resolution of the constrictive physiologic features occurred at an average of 8.3 weeks after diagnosis.

CONCLUSIONS: A subset of patients with CP experience resolution of the disorder without requiring pericardiectomy.

Abbreviations and Acronyms   CP = constrictive pericarditis   NSAID = nonsteroidal anti-inflammatory drug   PE = pericardial effusion

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