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Tuberculous constrictive pericarditis: challenges and surgical management
Sridevi Chigullapalli1, Susheel Kumar Malani1, Ajitkumar Krishna Jadhav1
1Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India.
BMJ Case Reports
|September 5, 2025
Summary
Constrictive pericarditis, an inflammation causing stiffening of the heart
Area of Science:
- Cardiology
- Infectious Diseases
- Thoracic Surgery
Background:
- Constrictive pericarditis is characterized by inflammation and loss of elasticity of the pericardium, restricting ventricular filling.
- Symptoms include dyspnea and pedal edema, often indicative of right-sided heart failure.
- Tuberculous etiology is a significant cause of constrictive pericarditis, particularly in endemic regions.
Purpose of the Study:
- To present a case of constrictive pericarditis with myocardial involvement and tuberculous etiology.
- To highlight the diagnostic challenges and clinical course of this condition.
- To emphasize the importance of early diagnosis and management for improved patient outcomes.
Main Methods:
- Case report of a male patient in his 50s presenting with symptoms of heart failure.
- Diagnostic workup included echocardiography and cardiac computed tomography.
- Surgical pericardiectomy followed by histopathological examination of pericardial tissue.
Main Results:
- Echocardiography and CT revealed features of chronic constrictive pericarditis with septal involvement and calcific deposits.
- Histopathology confirmed tuberculous etiology.
- The patient experienced postoperative heart failure and ultimately died, indicating poor prognosis with myocardial involvement.
Conclusions:
- Constrictive pericarditis with myocardial involvement carries a poor prognosis, even after surgical intervention.
- Early diagnosis and prompt management are crucial for improving outcomes.
- Tuberculosis should be considered in the differential diagnosis of constrictive pericarditis, especially in at-risk populations.
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