Why the study?
Calcific constrictive pericarditis remains a rare and challenging entity that often masquerades as other cardiopulmonary conditions, leading to delayed diagnosis.
This case report highlights the diagnostic and therapeutic challenges of calcific constrictive pericarditis in a medically complex patient with multiple comorbidities where high surgical risk necessitated conservative and palliative management over pericardiectomy.
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Highlights palliative considerations in inoperable calcific constrictive pericarditis; leaves open research on nonsurgical options.
Despite advances in imaging and diagnostics, calcific constrictive pericarditis (CCP) remains a rare and challenging entity, often masquerading as other cardiopulmonary conditions, leading to delayed diagnosis. We present a 70-year-old male with a history of heart failure, atrial fibrillation (AF), cirrhosis, chronic obstructive pulmonary disease (COPD), and prior pleural effusion, who was admitted with acute hypoxic respiratory failure and AF with rapid ventricular response (RVR). Imaging revealed extensive pericardial calcifications, leading to a diagnosis of CCP. The patient's clinical course was marked by refractory hypotension, altered mental status, and progressive cardiohepatic syndrome. Given his high surgical risk, he was managed conservatively and transitioned to palliative care. This case underscores the diagnostic and therapeutic challenges of CCP, particularly in patients with complex comorbidities where surgical intervention is not feasible. It highlights the need for early recognition and individualized management strategies to optimize outcomes in this challenging subset of patients.
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Kasula et al. (2025) studied this question.
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