Transient constrictive pericarditis following acute idiopathic pericarditis. A case report

acute pericarditis; transient constrictive pericarditis; permanent constriction A 53-year-old woman was admitted in hospital because of low-grade fever of 1-week duration along with chest pain, dyspnea, fatigue, and myalgias.Her past medical history was notable for long-standing arterial hypertension treated with a fixed combination of a beta-blocker and diuretic.The pain was retrosternal with irradiation to the neck and jaws.Notably, it was relieved by sitting up and leaning forward, while it worsened with deep inspiration, cough, and lying down.On admission, the patient was anxious but in a good overall condition.The blood pressure was 135/80 mmHg without pulsus paradoxus.Physical examination was remarkable for the presence of a pericardial friction rub.Auscultation of the lungs revealed decreased breath sounds toward the base of both lungs.Moreover, jugular vein distension, mild ankle edema, and presence of a palpable liver 3 cm below the right costal margin were detected.Laboratory evaluation revealed greatly elevated C reactive protein levels (298 mg/dl with normal values <5) along with mild elevation of creatinine and aminotransferases (both approximately Â1.5 the upper limit of normal).The rest of the hematologic tests, including highsensitivity troponin serum levels, quantiferon test for tuberculosis, serologic screening for connective tissue diseases, thyroid hormone levels, and serum tumor marker measurements were unremarkable.