[Hepatomegaly as a form of presentation in constrictive pericarditis. A pediatric clinical case]

Area of Science:

• Cardiology
• Pediatrics
• Pathology

Background:

• Constrictive pericarditis is a rare pediatric condition characterized by pericardial fibrosis limiting cardiac diastole.
• Etiologies include idiopathic causes and Mycobacterium tuberculosis infection.
• Diagnosis is challenging due to oligosymptomatic presentation and potential misdirection by signs mimicking liver disease.

Observation:

• The case involves a 16-year-old patient presenting with hepatomegaly and mild dyspnea during a routine check-up.
• Symptoms like edema, ascites, and impaired liver function can obscure the diagnosis, suggesting primary liver disease.
• A high index of clinical suspicion is crucial for accurate diagnosis.

Findings:

• Fibrosis of the pericardium restricts diastolic filling of the heart.
• Clinical history, physical examination, and imaging are essential diagnostic cornerstones.
• Surgical treatment offers a curative outcome in most cases.

Implications:

• Highlights the importance of considering constrictive pericarditis in pediatric patients with unexplained hepatomegaly and dyspnea.
• Emphasizes the need for thorough clinical evaluation to differentiate from primary hepatic or other conditions.
• Underscores the curable nature of constrictive pericarditis with timely surgical management.