Constrictive pericarditis x-ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.

Plain chest radiographs in patients with constrictive pericarditis may show pericardial calcification, small cardiac silhouette (uncomplicated CP), large cardiac silhouette (if CP coexist with cardiomyopathy). Less reliable plain radiographic findings include an abnormal cardiac contour, such as straightening of the right atrial border and, more rarely, straightening of the right and left cardiac borders, with obliteration of the normal curves, on frontal images. The absence of calcification does not exclude the diagnosis of constrictive pericarditis.

Plain chest radiographs may show the following:

• Pericardial calcification
• Small cardiac silhouette (uncomplicated CP)
• Large cardiac silhouette (if CP coexist with cardiomyopathy)

Less reliable plain radiographic findings include an abnormal cardiac contour, such as

• Straightening of the right atrial border
• Straightening of the right and left cardiac borders, with obliteration of the normal curves, on frontal images. (more rarely)

The absence of calcification does not exclude the disease

• Pleural effusion (44–50% of patients with CP ), bilateral or unilateral