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.
This procedure has significant risk involved, with mortality rates of 6% or higher in major referral centers.A poor outcome is almost always the result after a pericardiectomy is performed for constrictive pericarditis whose origin was radiation-induced, further some patients may develop heart failure post-operatively. References
Further reading
Hoit, B. D. (25 June 2002). "Management of Effusive and Constrictive Pericardial Heart Disease". Circulation. 105 (25): 2939–2942. doi:10.1161/01.CIR.0000019421.07529.C5. PMID 12081983. Retrieved 21 September 2015. == External links ==