Constrictive pericarditis epidemiology and demographics

Template:Pericardial constriction Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Atif Mohammad, M.D.

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 1 in 10,000 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 6years, 9 patients developed constrictive pericarditis among whom 2 patients had viral/idiopathic etiology. Incidence rates of constrictive pericarditis per person years observed were as follows:

Incidence rates

Idiopathic/viral pericarditis	0.76 cases per 1000 person years
Connective tissue disease/pericardial injury	4.40 cases per 1000 person years
Malignant pericarditis	6.33 cases per 1000 person years
Tuberculous pericarditis	31.65 cases per 1000 person years
Purulent pericarditis	52.74 cases per 1000 person years