During diastole, less blood flow in left ventricle allows for more room for filling in right ventricle and therefore a septal shift occurs.During expiration, the amount of blood entering the left ventricle will increase, allowing the interventricular septum to bulge towards the right ventricle, decreasing the right heart ventricular filing. Diagnosis
The diagnosis of constrictive pericarditis is often difficult to make. In particular, restrictive cardiomyopathy has many similar clinical features to constrictive pericarditis, and differentiating them in a particular individual is often a diagnostic dilemma. Chest X-Ray - pericardial calcification (common but not specific), pleural effusions are common findings. Echocardiography - the principal echographic finding is changes in cardiac chamber volume. CT and MRI - CT scan is useful in assessing the thickness of pericardium, calcification, and ventricular contour. Cardiac MRI may find pericardial thickening and pericardial-myocardial adherence. Ventricular septum shift during breathing can also be found using cardiac MRI. Late gadolinium enhancement can show enhancement of the pericardium due to fibroblast proliferation and neovascularization. BNP blood test -  tests for the existence of the cardiac hormone brain natriuretic peptide, which is only present in restrictive cardiomyopathy but not in constrictive pericarditis
Conventional cardiac catheterization
Physical examination - can reveal clinical features including Kussmauls sign and a pericardial knock. Treatment
The definitive treatment for constrictive pericarditis is pericardial stripping, which is a surgical procedure where the entire pericardium is peeled away from the heart.
Paricalcitol (chemically it is 19-nor-1,25-(OH)2-vitamin D2. Marketed by Abbott Laboratories under the trade name Zemplar) is a drug used for the prevention and treatment of secondary hyperparathyroidism (excessive secretion of parathyroid hormone) associated with chronic kidney failure. It is an analog of 1,25-dihydroxyergocalciferol, the active form of vitamin D2 (ergocalciferol). It was patented in 1989 and approved for medical use in 1998. Medical uses
Its primary use in medicine is in the treatment of secondary hyperparathyroidism associated with chronic kidney disease. However current evidence is not sufficient to demonstrate an advantage of paricalcitol over non-selective vitamin D derivatives for this indication. Adverse effects
Adverse effects by frequency:Very common (>10% frequency):

NauseaCommon (1-10% frequency):

Uncommon (0.1-1% frequency):

‡ These are adverse effects only seen in patients with grade 3 or 4 chronic kidney disease. † These are adverse effects only seen in patients with grade 5 chronic kidney disease. Contraindications
Contraindications include:
Vitamin D intoxication
Hypercalcaemia
Hypersensitivity to paricalcitol or any of its excipientswhereas cautions include:
Impaired liver function
It is also advised that physicians regularly monitor their patients calcium and phosphorus levels. Interactions
Drugs that may interact with paricalcitol include:

Overdose
Electrolyte abnormalities (e.g. hypercalcaemia and hyperphosphataemia) are common overdose symptoms. Treatment is mostly supportive, with particular attention being paid to correcting electrolyte anomalies and reducing intake of calcium in both the form of supplementation and diet.