Constrictive pericarditis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Atif Mohammad, M.D.; Huda A. Karman, M.D.

Overview

Constriction can occur after almost any pericardial process. Historically, the most common etiology was tuberculosis, but in the modern age, this cause now accounts for <2% of cases. In a study of 95 patients undergoing pericardiectomy at Stanford, no cause could be found in 42% of patients. 31% occurred after radiotherapy, particularly following high dose mantle radiation for Hodgkin’s disease. Pericardial constriction occurred a mean of 85 months after radiotherapy, but occurred as early as 1 month and as late as 244 months. It also occurred post-operatively in 11% of cases. Connective tissue disorders accounted for 4%, neoplasm 3%, uremia 2% and sarcoidosis for 1% of cases. The likelihood of a constrictive pericarditis diagnosis is less than 10 in 100,000 hospital admissions considering only 9% of acute pericarditis patients develop pericardial constriction. This disease is more prevalent in males with a male-to-female ratio of 3:1. Constrictive pericarditis has been documented in people 8-70 years of age, with a median of 61 years of age.

Epidemiology and Demographics

Constriction can occur after almost any pericardial process. Historically, the most common etiology was tuberculosis, but in the modern age, this cause now accounts for <2% of cases. In a study of 95 patients undergoing pericardiectomy at Stanford, no cause could be found in 42% of patients. 31% occurred after radiotherapy, particularly following high dose mantle radiation for Hodgkin’s disease. Pericardial constriction occurred a mean of 85 months after radiotherapy, but occurred as early as 1 month and as late as 244 months. It also occurred post-operatively in 11% of cases. Connective tissue disorders accounted for 4%, neoplasm 3%, uremia 2% and sarcoidosis for 1% of cases.

The likelihood of a constrictive pericarditis diagnosis is less than 10 in 100,000 hospital admissions considering only 9% of acute pericarditis patients develop pericardial constriction. This disease is more prevalent in males with a male-to-female ratio of 3:1. Constrictive pericarditis has been documented in people 8-70 years of age, with a median of 61 years of age.

In a prospective study, 500 patients with acute pericarditis were followed over 8 years. At a median follow-up of 6 years, 9 patients developed constrictive pericarditis among whom 2 patients had viral/idiopathic etiology.[1] Incidence rates of constrictive pericarditis per person years observed were as follows:

Incidence rates[1]
Idiopathic/viral pericarditis 76 cases per 100,000 person years
Connective tissue disease/pericardial injury 440 cases per 100,000 person years
Malignant pericarditis 633 cases per 100,000 person years
Tuberculous pericarditis 3165 cases per 100,000 person years
Purulent pericarditis 5274 cases per 100,000 person years

References

  1. 1.0 1.1 Imazio M, Brucato A, Maestroni S, Cumetti D, Belli R, Trinchero R; et al. (2011). "Risk of Constrictive Pericarditis After Acute Pericarditis". Circulation. doi:10.1161/CIRCULATIONAHA.111.018580. PMID 21844077.


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