Constrictive pericarditis with pericardial calcification

Constrictive pericarditis is a chronic inflammatory condition of the pericardium, with an incidence of 1 in 100,000 in the US. It is often initiated by idiopathic or viral pericarditis, previous cardiac surgery, mediastinal radiation or tuberculosis, and is thought to be triggered by an immune response, leading to the development of a fibrous or calcific pericardium. In one series, 28% of resected pericardium specimens were grossly calcified on pathology. Symptoms are similar to those of heart failure, and the condition is difficult to distinguish from restrictive cardiomyopathy. Bilateral cardiac catheterization is the gold standard diagnostic test, and definitive management is pericardiectomy. Here, An and Singh examine the case 71-year-old man with constrictive pericarditis.