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Effusive-Constrictive Pericarditis — EECC MCQ

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HardPericardial DiseaseEffusive-Constrictive PericarditisEECC

A 55-year-old man with a history of tuberculous pericarditis presents with features of both pericardial effusion and constrictive physiology on echocardiography (pericardial effusion with septal bounce, elevated JVP, and restrictive mitral inflow). What is this entity called?

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Correct answer: D — Effusive-constrictive pericarditis

Effusive-constrictive pericarditis is a distinct entity characterised by the coexistence of a pericardial effusion and constrictive physiology of the visceral pericardium. The hallmark finding is that after pericardiocentesis (which relieves the tamponade component), elevated right atrial pressures persist due to the underlying constriction. It is most commonly caused by tuberculosis, post-radiation, or idiopathic/viral pericarditis that has progressed to involve the visceral pericardium. The 2025 ESC Pericarditis Guidelines recognise it as a stage in the progression from acute pericarditis to constrictive pericarditis. Treatment may include anti-inflammatory therapy (to address potentially reversible inflammatory constriction) and pericardiectomy for refractory cases.

Reference: ESC (2025): Guidelines for Myocarditis and Pericarditis