Protocolo diagnóstico y diagnóstico diferencial de la pericarditis constrictiva

Constrictive pericarditis should be considered in any patient with an unexplained elevated jugular venous pressure and fluid overload. Complementary test findings as relatively low plasma concentrations of brain natriuretic peptide (BNP), electrocardiogram with low voltage and nonspecific T-wave repolarization abnormalities may support the clinical suspicion. Pericardial calcifications may be noted on the chest radiograph, although absence of calcification does not exclude constrictive pericarditis. The diagnosis is confirmed with: constrictive physiology proved by echocardiography or invasive hemodynamic study, or pericardial thickening with or without calcification by cardiac computed tomography and cardiac magnetic resonance imaging. Results of both imaging modalities will help plan surgery.