Cholesterol Pericarditis

Cholesterol pericarditis is a rare condition characterized by cholesterol crystal accumulation in the pericardium, often linked to hyperlipidemia and chronic inflammatory disorders. A 50-year-old woman with a history of hypercholesterolemia presented with progressive dyspnea, chest pain, and fatigue. Clinical evaluation and imaging studies revealed a massive pericardial effusion. Pericardiocentesis was performed, and fluid analysis demonstrated the presence of cholesterol crystals. The patient was treated with pericardiocentesis, nonsteroidal anti-inflammatory drugs, and lipid-lowering therapy, leading to rapid symptom resolution. Cholesterol pericarditis remains an underrecognized cause of pericardial effusion. A high index of suspicion is required in patients presenting with unexplained pericardial effusion. Diagnosis is primarily based on pericardial fluid analysis. Management includes symptomatic relief with pericardiocentesis, anti-inflammatory therapy, and long-term lipid control to prevent recurrence. Cholesterol pericarditis should be considered in patients with unexplained pericardial effusion and dyslipidemia. Early diagnosis and treatment can lead to favorable outcomes.