September 1, 2025Open Access
View Full PaperIdentifying Constrictive Pericarditis With Multimodality Imaging
Key Result
Pericardiectomy successfully relieved symptoms and volume overload in a 35-year-old man with idiopathic constrictive pericarditis whose diagnosis was delayed by discordant multimodality imaging.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
A 35-year-old man presenting with dyspnea, orthopnea, and edema for 9 months diagnosed with idiopathic constrictive pericarditis.
I
Intervention
pericardiectomy
O
Outcome
relief of symptoms and volume overload
Constrictive pericarditis should be considered in patients with heart failure and preserved ejection fraction, though multimodality imaging can sometimes yield discordant results delaying diagnosis.
Abstract
BACKGROUND: Constrictive pericarditis is a chronic inflammatory process characterized by scarring, fibrosis, and calcification of the pericardium which often progresses to diastolic dysfunction, low cardiac output, and heart failure. CASE SUMMARY: We report a case of a 35-year-old man presenting with dyspnea, orthopnea, and edema for 9 months who was ultimately diagnosed with idiopathic constrictive pericarditis. He underwent successful pericardiectomy with relief of symptoms and volume overload. DISCUSSION: Constrictive pericarditis is a potentially curable form of heart failure with pericardiectomy. Diagnosis is confirmed by echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and invasive hemodynamic evaluation. The clinical diagnosis in this patient was delayed by discordant results from multimodality imaging. This report underscores the clinical challenge of making a diagnosis of a rare disease despite multimodality imaging. TAKE-HOME MESSAGE: In patients presenting with clinical symptoms of heart failure and preserved left ventricular ejection fraction, constrictive pericarditis is one of the potential etiologies.