Calcific pericarditis strangling the heart, an answer to unexplained heart failurediagnostic modalities

Area of Science:

• Cardiology
• Infectious Diseases
• Radiology

Background:

• Constrictive pericarditis is a challenging diagnosis due to its mimicry of heart failure, pulmonary, and liver diseases.
• Pericardial calcification on imaging may indicate constrictive pericarditis.
• Tuberculosis is the leading infectious cause of constrictive pericarditis globally.

Observation:

• A patient presented with progressive shortness of breath over five years, worsening in the last six months.
• The patient had a history of pulmonary tuberculosis.
• Cardiac CT revealed findings consistent with constrictive pericarditis.

Findings:

• The diagnosis of constrictive pericarditis was confirmed.
• Tuberculous etiology was suspected given the patient's history and geographical location (Indonesia).

Implications:

• Unexplained heart failure in developing countries warrants consideration of tuberculous constrictive pericarditis.
• Early diagnosis and treatment are crucial for managing constrictive pericarditis.
• Radiological findings of pericardial calcification should prompt further investigation for constrictive pericarditis.