Related Experiment Video
Updated: May 21, 2025
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
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.
Insights
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.
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.
Abstract:
Despite advances in imaging and diagnostics, calcific constrictive pericarditis (CCP) remains a rare and challenging entity, often masquerading as other cardiopulmonary conditions, leading to delayed diagnosis. We present a 70-year-old male with a history of heart failure, atrial fibrillation (AF), cirrhosis, chronic obstructive pulmonary disease (COPD), and prior pleural effusion, who was admitted with acute hypoxic respiratory failure and AF with rapid ventricular response (RVR). Imaging revealed extensive pericardial calcifications, leading to a diagnosis of CCP. The patient's clinical course was marked by refractory hypotension, altered mental status, and progressive cardiohepatic syndrome. Given his high surgical risk, he was managed conservatively and transitioned to palliative care. This case underscores the diagnostic and therapeutic challenges of CCP, particularly in patients with complex comorbidities where surgical intervention is not feasible. It highlights the need for early recognition and individualized management strategies to optimize outcomes in this challenging subset of patients.
Related Concept Videos
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...