Role of hepatic and portal venous Doppler in constrictive pericarditis: insights from a case series

Abstract Background Constrictive pericarditis is characterized by diffuse thickening, fibrosis, and calcification of the pericardium, leading to diastolic dysfunction and heart failure. Echocardiographic assessment typically focuses on trans-mitral and trans-tricuspid inflows as well as venous flows in the superior vena cava, pulmonary veins, and hepatic veins. The diagnostic and perioperative utility of hepatic and portal venous Doppler assessment in constrictive pericarditis, however, remains insufficiently explored. Case summary We present a case series of patients with constrictive pericarditis in whom portal and hepatic venous Doppler interrogation was performed alongside conventional echocardiographic evaluation. The Doppler findings were integrated into the perioperative management strategy, contributing to a comprehensive understanding of venous return dynamics in these patients. Discussion Our experience highlights the potential role of portal and hepatic venous Doppler assessment in the perioperative evaluation of constrictive pericarditis. These parameters may provide incremental value by complementing standard echocardiographic indices, thereby offering additional haemodynamic insights and facilitate tailored perioperative management. Further studies are warranted to validate their diagnostic and prognostic significance in this context.