Potential of Magnetic Resonance Imaging in Diagnostics of Transient Constrictive Pericarditis

The article addresses the diagnostic criteria based on magnetic resonance imaging (MRI) in transient constrictive pericarditis (TCP), a rare form of constrictive pericarditis characterized by temporary signs of constriction. Constrictive pericarditis evident as myocardial thickening and fibrosis results in impaired diastolic filling and can manifest itself with symptoms similar to those of other pathologies, such as restrictive cardiomyopathy. The article presents two clinical cases of TCP, where the role of MRI in the diagnosis and monitoring of patients is highlighted. For diagnostics, echocardiography and MRI were used along with laboratory tests, including the tests for inflammation markers and troponin. MRI allows not only to visualize changes in the pericardial structure but also to monitor changes in the condition, which is important for choosing the treatment tactics. In both cases, symptoms were successfully resolved, and the patients' condition was normalized with drug therapy. The results highlight the importance of early diagnosis and proper management tactics to prevent irreversible changes in the pericardium and heart failure.

1. Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Russian Journal of Cardiology. 2016;21(5):117–62. DOI: 10.15829/1560-4071-2016-5-117-162

2. Welch TD, Oh JK. Constrictive Pericarditis. Cardiology Clinics. 2017;35(4):539–49. DOI: 10.1016/j.ccl.2017.07.007

3. Gillombardo CB, Hoit BD. Constrictive pericarditis in the new millennium. Journal of Cardiology. 2024;83(4):219–27. DOI: 10.1016/j.jjcc.2023.09.003

4. Haley JH, Tajik AJ, Danielson GK, Schaff HV, Mulvagh SL, Oh JK. Transient constrictive pericarditis: causes and natural history. Journal of the American College of Cardiology. 2004;43(2):271–5. DOI: 10.1016/j.jacc.2003.08.032

5. Baritussio A, Giordani AS, Iliceto S, Marcolongo R, Caforio ALP. Transient pericardial constriction: A not so rare entity. International Journal of Cardiology. 2023;390:131225. DOI: 10.1016/j.ijcard.2023.131225

6. Yamamoto H, Isogai J. Transient constrictive pericarditis following coxsackievirus A4 infection as a rare cause of acute mediastinitis: A case report. Heliyon. 2023;9(9):e19555. DOI: 10.1016/j.heliyon.2023.e19555

7. Antonopoulos AS, Vrettos A, Androulakis E, Kamperou C, Vlachopoulos C, Tsioufis K et al. Cardiac magnetic resonance imaging of pericardial diseases: a comprehensive guide. European Heart Journal – Cardiovascular Imaging. 2023;24(8):983–98. DOI: 10.1093/ehjci/jead092

8. Gentry J, Klein AL, Jellis CL. Transient Constrictive Pericarditis: Current Diagnostic and Therapeutic Strategies. Current Cardiology Reports. 2016;18(5):41. DOI: 10.1007/s11886-016- 0720-2

9. Hancock EW. On the elastic and rigid forms of constrictive pericarditis. American Heart Journal. 1980;100(6 Pt 1):917–23. DOI: 10.1016/0002-8703(80)90074-5

10. Sagrista-Sauleda J, Permanyer-Miralda G, Candell-Riera J, Angel J, Soler-Soler J. Transient cardiac constriction: an unrecognized pattern of evolution in effusive acute idiopathic pericarditis. The American Journal of Cardiology. 1987;59(9):961–6. DOI: 10.1016/0002-9149(87)91134-9

11. Bogaert J, Francone M. Cardiovascular magnetic resonance in pericardial diseases. Journal of Cardiovascular Magnetic Resonance. 2009;11(1):14. DOI: 10.1186/1532-429X-11-14

12. Verhaert D, Gabriel RS, Johnston D, Lytle BW, Desai MY, Klein AL. The role of multimodality imaging in the management of pericardial disease. Circulation. Cardiovascular Imaging. 2010;3(3):333–43. DOI: 10.1161/CIRCIMAGING.109.921791

13. Cosyns B, Plein S, Nihoyanopoulos P, Smiseth O, Achenbach S, Andrade MJ et al. European Association of Cardiovascular Imaging (EACVI) position paper: multimodality imaging in pericardial disease. European Heart Journal - Cardiovascular Imaging. 2015;16(1):12–31. DOI: 10.1093/ehjci/jeu128