An eye-opening case report of constrictive pericarditis

Sebastiaan Dhont; Yves Van Belleghem; Julie De Zaeytijd; Els Vandecasteele

doi:10.1093/ehjcr/ytac287

July 1, 2022European Heart Journal - Case ReportsOpen Access

An eye-opening case report of constrictive pericarditis

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Key Points

To describe an atypical presentation of constrictive pericarditis characterized primarily by sudden ophthalmologic symptoms.
Clinical evaluation of a young woman presenting with sudden vision reduction and visual floaters.
Comprehensive diagnostic assessment integrating non-invasive cardiac imaging with invasive hemodynamic assessment.
Invasive hemodynamic testing confirmed a diagnosis of constrictive pericarditis characterized by impaired diastolic filling.
Severe systemic venous congestion secondary to pericardial constraint was identified as the underlying cause of the patient's ocular symptoms.

Structured PICO

P

Population

A young woman presenting with sudden appearance of floaters and vision reduction, eventually diagnosed with constrictive pericarditis.

I

Intervention

Invasive haemodynamic assessment

O

Outcome

Diagnosis of constrictive pericarditis

Constrictive pericarditis can present atypically with ocular symptoms (floaters and vision reduction) due to venous congestion.

Implication

Constrictive pericarditis may present with ocular symptoms from venous congestion; extends known manifestations but leaves open broader applicability.

Abstract

Background: Constrictive pericarditis is characterized by the encasement of the heart by a stiff pericardium leading to impaired diastolic function, which ultimately leads to congestive heart failure. Case summary: We report a case of a young woman, who first presented to the ophthalmologist with the sudden appearance of floaters and vision reduction. Eventually, invasive haemodynamic assessment led to the diagnosis of constrictive pericarditis leading to venous congestion. Conclusion: Understanding the pathophysiology and integrating the results of invasive and non-invasive diagnostic work up is important in making this challenging diagnosis.