Constrictive pericarditis epidemiology and demographics: Difference between revisions
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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. | 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 | 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 | 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.<ref name="pmid21844077">{{cite journal| author=Imazio M, Brucato A, Maestroni S, Cumetti D, Belli R, Trinchero R et al.| title=Risk of Constrictive Pericarditis After Acute Pericarditis. | journal=Circulation | year= 2011 | volume= | issue= | pages= | pmid=21844077 | doi=10.1161/CIRCULATIONAHA.111.018580 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21844077 }} </ref> Incidence rates of constrictive pericarditis per person years observed were as follows: | ||
{| class="wikitable" border="1" | {| class="wikitable" border="1" | ||
|+ Incidence rates<ref name="pmid21844077">{{cite journal| author=Imazio M, Brucato A, Maestroni S, Cumetti D, Belli R, Trinchero R et al.| title=Risk of Constrictive Pericarditis After Acute Pericarditis. | journal=Circulation | year= 2011 | volume= | issue= | pages= | pmid=21844077 | doi=10.1161/CIRCULATIONAHA.111.018580 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21844077 }} </ref> | |+ Incidence rates<ref name="pmid21844077">{{cite journal| author=Imazio M, Brucato A, Maestroni S, Cumetti D, Belli R, Trinchero R et al.| title=Risk of Constrictive Pericarditis After Acute Pericarditis. | journal=Circulation | year= 2011 | volume= | issue= | pages= | pmid=21844077 | doi=10.1161/CIRCULATIONAHA.111.018580 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21844077 }} </ref> | ||
| Idiopathic/viral pericarditis || | | Idiopathic/viral pericarditis || 76 cases per 100,000 person years | ||
|- | |- | ||
| Connective tissue disease/pericardial injury || | | Connective tissue disease/pericardial injury || 440 cases per 100,000 person years | ||
|- | |- | ||
| [[Malignant pericarditis]] || | | [[Malignant pericarditis]] || 633 cases per 100,000 person years | ||
|- | |- | ||
| [[Tuberculous pericarditis]] || | | [[Tuberculous pericarditis]] || 3165 cases per 100,000 person years | ||
|- | |- | ||
| Purulent pericarditis || | | Purulent pericarditis || 5274 cases per 100,000 person years | ||
|} | |} | ||
Revision as of 19:44, 2 April 2013
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 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:
| 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
- ↑ 1.0 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.