Constrictive Pericarditis in Sub-Saharan Africa: A Scoping Review of Diagnostic Pathways, Surgical Pericardiectomy Outcomes, and Systemic Bottlenecks

Constrictive pericarditis represents a debilitating sequela of chronic pericardial inflammation, predominantly driven by Mycobacterium tuberculosis in sub-Saharan Africa. Although surgical pericardiectomy offers the only definitive cure, patients across the subcontinent face prolonged diagnostic delays, high perioperative mortality, and severe health-system constraints. Existing regional evidence consists largely of fragmented, single-center surgical series with no unified synthesis evaluating clinical pathways or surgical access. This scoping review aims to systematically map the literature on constrictive pericarditis in sub-Saharan Africa following Joanna Briggs Institute and PRISMA-ScR guidelines. Specifically, it will evaluate real-world diagnostic modalities, chart immediate and mid-term surgical outcomes following pericardiectomy, and identify structural health-system bottlenecks including delayed referral, limited cardiothoracic infrastructure, and financial barriers. Ultimately, this work will define critical gaps across the surgical care cascade and provide an evidence base to guide clinical decision-making, optimize referral pathways, and inform health policy across the region.