Key result
Subtotal pericardiectomy rapidly resolves HF symptoms and normalizes RV function in a constrictive pericarditis case.
Case Report (n=1)
Subtotal pericardiectomy can successfully resolve heart failure symptoms and restore right ventricular function in patients with constrictive pericarditis secondary to purulent pericarditis.
May support subtotal pericardiectomy for symptom relief in rare purulent pericarditis constriction; hypothesis-generating Level 5 data leaves generalizability open.
Constrictive pericarditis (CP) is a rare but serious condition characterized by pericardial fibrosis and impaired ventricular filling, often resulting in progressive heart failure. Infectious pericarditis, particularly purulent forms, is a severe etiology requiring early recognition and intervention. A 64-year-old male with a history of Staphylococcus aureus pericarditis presented with worsening dyspnea and signs of right heart failure. Imaging revealed a thickened, fibrotic pericardium with mild effusion, while cardiac catheterization confirmed CP with equalized diastolic pressures and a dip-plateau phenomenon. Given his clinical deterioration, he underwent subtotal pericardiectomy with pericardial reconstruction. Intraoperatively, severe adhesions were noted, necessitating extensive pericardial resection. The patient showed rapid postoperative improvement, with a resolution of heart failure symptoms and normalization of right ventricular function. This case highlights the importance of timely diagnosis and surgical intervention in CP following infectious pericarditis. Pericardiectomy remains the definitive treatment, with early recognition being key to optimizing patient outcomes.
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Leivaditis et al. (2025) conducted a case report in Constrictive pericarditis following purulent pericarditis (n=1). Subtotal pericardiectomy with pericardial reconstruction was evaluated on Resolution of heart failure symptoms and normalization of right ventricular function. Subtotal pericardiectomy resulted in rapid resolution of heart failure symptoms and normalization of right ventricular function in a 64-year-old male with constrictive pericarditis.
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