Only 50% of patients with pericardial calcifications have constrictive pericarditis. Constrictive pericarditis occurs between the ages of 30-50 years, M:F 3:1. Most common cause of constrictive pericardial disease is postpericardiotomy and hemopericardium for any reason. The second most common cause is radiation therapy, but Coxsackie B virus, TB, uremia, connective tissue disease, neoplasm, and idiopathic etiologies may be seen.
Normal pericardial thickness is less than 2mm. When greater than 4mm and accompanied by clinical findings of heart failure, constrictive pericarditis is highly likely.
Imaging Findings in Cardiac Tamponade with Emphasis on CT
- Enlarged SVC with diameter equal to adjacent aorta
- Enlarged IVC with diameter twice adjacent aorta
- Reflux into hepatic or azygous veins
- Enlargement of hepatic or renal veins