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Lessons From a Complex Case of Calcific Constrictive Pericarditis: A Case Report.

Varun Kasula¹, Vikram Padala², Jagroop Doad¹

¹Department of Cardiology, Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA.

Case Reports in Cardiology

|May 19, 2025

Summary

Calcific constrictive pericarditis (CCP) is a rare condition mimicking other diseases, causing diagnostic delays. This case highlights challenges in managing CCP in patients with multiple health issues, emphasizing individualized care.

Keywords:

calcific constrictive pericarditis diastolic dysfunction pericardial calcification pericardiectomy septal bounce

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Published on: February 4, 2021

Area of Science:

Cardiology
Pulmonology
Gastroenterology

Background:

Calcific constrictive pericarditis (CCP) presents diagnostic challenges due to its rarity and nonspecific symptoms.
Patients with multiple comorbidities, including heart failure, atrial fibrillation (AF), cirrhosis, and chronic obstructive pulmonary disease (COPD), often experience delayed CCP diagnosis.

Observation:

A 70-year-old male with a complex medical history presented with acute hypoxic respiratory failure and rapid ventricular response AF.
Extensive pericardial calcifications were identified, leading to a diagnosis of CCP.
The patient exhibited refractory hypotension, altered mental status, and progressive cardiohepatic syndrome.

Findings:

The patient's comorbidities precluded surgical intervention, necessitating conservative management.
The clinical course was complicated by refractory hypotension and cardiohepatic syndrome, indicative of advanced disease.
Transition to palliative care was deemed appropriate due to high surgical risk and disease severity.

Implications:

This case highlights the critical need for early recognition of CCP, especially in patients with complex comorbidities.
Individualized management strategies are essential for optimizing outcomes in challenging CCP cases.
The diagnostic and therapeutic hurdles associated with CCP in high-risk patients require further investigation and tailored approaches.