How often can constrictive pericarditis occur after acute pericarditis?

Overall, one sixth to one third of persons can have recurrent pericarditis after an episode of acute pericarditis. Of these, half may have recurrent symptoms and some may need pericardiectomy. In one series with 500 patients, 1.8% developed constrictive pericarditis. But constriction can occur very long after an episode of pericarditis like one two decades later, when the initial episode may be forgotten. Fortunately constrictive pericarditis is rare after the most common etiology of pericarditis which is viral or idiopathic, with only about half a percent likelihood. Likelihood is higher with other etiologies like neoplastic, post pericardial injury and bacterial pericarditis, at about 8.3%. Tuberculous pericarditis can be followed by constriction at a rate of about 32 cases per 1000 person years, while the corresponding figure for purulent pericarditis is about 53 cases.

Reference

1. Al-Kazaz M, Klein AL, Oh JK, Crestanello JA, Cremer PC, Tong MZ, Koprivanac M, Fuster V, El-Hamamsy I, Adams DH, Johnston DR. Pericardial Diseases and Best Practices for Pericardiectomy: JACC State-of-the-Art Review. J Am Coll Cardiol. 2024 Aug 6;84(6):561-580. doi: 10.1016/j.jacc.2024.05.048. PMID: 39084831.