Investigations of Constrictive pericarditis:
>Chest X-ray reveals pericardial calcification in 25% of patients with constrictive pericarditis.
>ECG shows non-specific ST-T changes and, perhaps, low voltage QRS.
>Echocardiography Increased pericardial thickness may be present (not necessarily) and can be better appreciated by transesophageal echocardiography. There is abnormal ventricular septal motion , and dilatation and absent or diminished collapse of the IVC and hepatic veins may be seen.
Preserved or increased early diastolic filling (peak early velocity of longitudinal expansion (peak Ea) ≥8.0 cm/s) is an important distinction from restrictive cardiomyopathy in which the E is diminished.
Doppler and M-mode markers of normal myocardial relaxation indicate constrictive pericarditis rather than restrictivre cardiomyopathy.
Increased hepatic vein flow reversal with expiration , reflects the ventricular interaction and the dissociation of the intracardiac and intrathoracic pressures.
>Cardiac catheterization It is indicated when non-invasive methods do not provide a definitive diagnosis.
> Cardiac CT and cardiac MR They can demonstrate increased pericardial thickness (>4 mm) and calcification.
