"The cry of a trapped heart"

Area of Science:

• Cardiology
• Gastroenterology
• Hepatology

Background:

• Constrictive pericarditis, particularly the idiopathic calcific type, can present insidiously.
• Dyspepsia and abnormal liver function tests may mask underlying cardiac pathology.
• Key physical findings include elevated jugular venous pressure, pulsus paradoxus, hepatomegaly, ascites, and edema.

Purpose of the Study:

• To report a case of idiopathic calcific constrictive pericarditis.
• To highlight the diagnostic challenges posed by atypical presentations.
• To demonstrate the efficacy of surgical intervention.

Main Methods:

• Case report of a patient referred for endoscopy.
• Clinical examination revealing signs of cardiac compromise.
• Diagnostic investigations confirming constrictive pericarditis.
• Surgical pericardiectomy as treatment.

Main Results:

• The patient presented with dyspepsia and abnormal liver function tests, obscuring cardiac symptoms.
• Physical examination revealed signs consistent with constrictive pericarditis.
• Idiopathic calcific constrictive pericarditis was diagnosed.
• Surgical pericardiectomy resulted in complete symptom resolution and normalized liver biochemistry.

Conclusions:

• Idiopathic calcific constrictive pericarditis requires high clinical suspicion, especially when presenting with non-specific symptoms.
• Early surgical pericardiectomy is an effective treatment for constrictive pericarditis.
• Prompt diagnosis and intervention can prevent long-term complications.