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Constrictive pericarditis is a long-term disorder in which the pericardium, the protective sac surrounding the heart, becomes thickened, scarred, and less flexible. This loss of elasticity prevents the heart chambers from expanding normally during filling, reducing the amount of blood pumped with each heartbeat. In some individuals, no specific cause is identified.

Common symptoms include swelling of the legs and abdomen, fatigue, shortness of breath, reduced exercise tolerance, and abdominal fullness from fluid accumulation. Physical examination may reveal elevated neck veins and signs of right-sided heart failure.

Diagnosis involves echocardiography, cardiac CT, MRI, electrocardiography, and occasionally cardiac catheterization to confirm restricted heart filling and evaluate pericardial thickening.

Treatment depends on severity and underlying cause. Anti-inflammatory medications and diuretics may relieve symptoms in selected patients. However, advanced or persistent constrictive pericarditis often requires surgical removal of the diseased pericardium, known as pericardiectomy. Early diagnosis and appropriate treatment can significantly improve heart function, reduce symptoms, and enhance long-term quality of life for many patients.