Chronic constrictive pericarditis induced by long-term bromocriptine therapy: report of two cases

To report two cases of chronic constrictive pericarditis that appear to be related to the intake of bromocriptine for Parkinson's disease.

Two white men (aged 63 and 69 y) were treated with bromocriptine for four (40 mg/d) and two years (30 mg/d), respectively, with a cumulative dose intake of 58.4 and 21.9 g, respectively. The patients experienced dyspnea with bilateral lower-limb edema and pleural effusion, suggesting right cardiac dysfunction. Echocardiography, computed tomography, and cardiac catheterization results were compatible with a diagnosis of constrictive pericarditis, so pericardectomy was performed on both patients. The anatomic pathology examination showed a fibrous pericardium; cultures were sterile. In the first case, pleural effusion recurred seven months after the pericarditis; bromocriptine was suspected and treatment was discontinued. In the second case, just prior to the pericardectomy, an episode of mental confusion occurred and prompted the cessation of bromocriptine therapy.

To the best of our knowledge, only one case of constrictive pericarditis induced by bromocriptine therapy has previously been described in the literature.

Our cases call attention to a possible association between bromocriptine use in patients who have Parkinson's disease and constrictive pericarditis.