The visceral pericardium is usually prominently involved.
In typical cardiac tamponade, right atrial pressures normalize after pericardiocentesis. Conversely, in ECP, increased right atrial pressure persists post-centesis, with constrictive features surfacing after the pericardial fluid has been drained (initially described as the development of deep x and y descents on right atrial tracings following pericardiocentesis).
The diagnosis of ECP is based on invasive hemodynamics, defined by right atrial pressures failing to drop below 10 mmHg or by ≥50% post-pericardiocentesis.
The most common causes of ECP are idiopathic, malignancy, radiation, post-pericardiotomy, and connective tissue diseases. Tuberculosis is the leading cause in sub-Saharan Africa.
In idiopathic and post-pericardiotomy cases, antiinflammatory treatment as described for non-effusive CP may provide a gratifying result with avoidance of pericardiectomy. Still, no guidance is available regarding a specific approach.
A pericardiectomy is ultimately required in many patients.
-IkaN
"This blog beautifully explains the nuanced differences between typical cardiac tamponade and ECP. Very informative!"
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"I didn’t know that ECP could persist post-pericardiocentesis. The role of x and y descents in diagnosis is fascinating!"
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"The fact that tuberculosis is the leading cause in sub-Saharan Africa highlights the importance of region-specific studies. Thanks for this insight!"
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"Great to see a clear explanation of invasive hemodynamics as a diagnostic tool for ECP. Very well written!"
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"I wish there were clearer guidelines on anti-inflammatory treatments for idiopathic cases. This blog sheds light on that gap effectively."
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"It’s amazing how advanced diagnostics like right atrial tracings help distinguish ECP from other pericardial issues. Thanks for sharing!"
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"I found the part about the visceral pericardium being prominently involved in ECP quite enlightening. Great detail!"
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"This post simplifies a complex topic like ECP and highlights its key causes. Very helpful for medical learners."
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"A well-structured post! It explains why pericardiectomy is often the ultimate solution in persistent ECP cases."
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"This blog emphasizes the importance of recognizing idiopathic and post-pericardiotomy cases early. Great takeaway!"
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