Role of Echocardiography in the Diagnosis of Constrictive Pericarditis

The clinical recognition of constrictive pericarditis (CP) is important but challenging. In addition to Doppler echocardiography, newer echocardiographic techniques for deciphering myocardial deformation have facilitated the noninvasive recognition of CP and its differentiation from restrictive cardiomyopathy. In a patient with heart failure and a normal ejection fraction, echocardiographic demonstration of exaggerated interventricular interdependence, relatively preserved left ventricular longitudinal deformation, and attenuated circumferential deformation is diagnostic of CP. This review is a concise update on the pathophysiology and hemodynamic features of CP, the transmural and torsional mechanics of CP, and the merits and pitfalls of the various echocardiographic techniques used in the diagnosis of CP.