Indications for Surgery : Once diagnosis of constrictive pericarditis is made and confirmed by chest X-ray, ECG, echocardiogram, CT, MRI scan, cardiac catheterisation and angio, surgical treatment should not be deferred. These tests help to differentiate constrictive pericarditis from restrictive cardiomyopathy.
The clinical presentation is dominated by signs and symptoms of right heart failure. There is reduced cardiac output due to reduced ventricular filling. In later' stages myocardium may be affected by infiltration and atrophy and surgery carries very high mortality. Patient should have surgery before myocardium is irreversibly damaged, leading to right heart failure and cardiac cirrhosis.