What is the definitive treatment for constrictive pericarditis?

• A. NSAIDs
• B. Steroids
• C. Pericardiectomy
• D. Diuretics

Answer: (C)

Constrictive pericarditis creates a noncompliant pericardial shell that physically limits the heart’s diastolic filling. Because the problem is mechanical rather than simply inflammatory or fluid-related, the only definitive way to restore normal filling is to remove that restrictive pericardium. Pericardiectomy—the surgical removal of the thickened pericardium—unlocks the ventricles, improves diastolic filling, and reduces venous pressures, often leading to symptom relief and better cardiac output.

Medical therapies like NSAIDs or steroids may be used if there’s ongoing inflammation or as part of initial management in some patients, and diuretics can help with congestion, but they do not eliminate the underlying constriction. Therefore they are not curative.