Fibrosepericardium

Fibrosepericardium, commonly referred to as fibrosing pericarditis, is a chronic inflammatory condition affecting the pericardium—the double-layered sac surrounding the heart. The pericardium consists of an inner visceral layer directly adhering to the heart and an outer parietal layer, with a thin fluid-filled space between them. In fibrosing pericarditis, persistent inflammation leads to excessive fibrous tissue formation, thickening the pericardium and restricting its normal function.

The exact cause of fibrosing pericarditis remains unclear, though it may arise spontaneously or follow an acute pericarditis episode. Autoimmune disorders, infections (such as viral or bacterial), radiation therapy, or certain medications have been linked to its development. Symptoms often include progressive dyspnea (difficulty breathing), chest pain, fatigue, and reduced exercise tolerance. In advanced cases, the condition can lead to cardiac tamponade—a life-threatening compression of the heart due to fluid accumulation—or constrictive pericarditis, where the stiffened pericardium impairs heart filling.

Diagnosis typically involves clinical evaluation, imaging studies like echocardiography or computed tomography (CT), and sometimes pericardial biopsy to confirm fibrosis. Treatment focuses on managing symptoms and preventing complications. Mild cases may require supportive care, while severe or constrictive forms often necessitate surgical pericardiectomy—removal of the fibrotic pericardium—to restore normal heart function. Medical therapies, such as anti-inflammatory drugs or immunosuppressive agents, may be used in select cases to control inflammation.

Prognosis varies depending on the extent of pericardial involvement and underlying causes. Early intervention improves outcomes, particularly in preventing irreversible cardiac damage. Long-term monitoring is essential for patients with fibrosing pericarditis to detect complications and adjust treatment as needed. Research continues to explore the pathogenesis of the condition to refine diagnostic and therapeutic approaches.