Treatment: Constrictive Pericarditis

Surgical stripping of the pericardium. Progressive improvement ensues over several months.

Approach to the Patient: Asymptomatic Pericardial Effusion of Unknown Cause

If careful history and physical examination do not suggest etiology, the following may lead to diagnosis:

• Testing for tuberculosis (Chap. 94. Tuberculosis and Other Mycobacterial Infections)
• Serum albumin and urine protein measurement (nephrotic syndrome)
• Serum creatinine and BUN (uremia)
• Thyroid function tests (myxedema)
• Antineutrophil antibodies (SLE and other collagen-vascular disease)
• Search for a primary tumor (especially lung and breast)

For a more detailed discussion, see Braunwald E: Pericardial Disease, Chap. 288, p. 1571, in HPIM-19.