Chronic idiopathic effusive pericarditis in a patient with 'cor pulmonale'

Chronic idiopathic pericarditis is a diagnosis of exclusion that is estimated to occur in 3.5% of primary pericardial disease. It is possible that many of these cases are secondary to unrecognised viral infections. The natural history is variable and treatment should be individualised, although chronic colchicines administration may hold promise as a newer therapeutic modality in symptomatic recurrent pericarditis. This case presentation illustrates the diagnostic and therapeutic difficulties that may arise in such patients.