Idiopathic Effusive Constrictive Pericarditis in a Young Patient: Early Diagnosis and Curative Surgical Treatment

We will present the case of a young man with a respiratory condition lasting for several months, treated with anti-inflammatory drugs and antibiotics, who, following an abdominal ultrasound that revealed pericardial fluid, was referred to the Emergency Department of Filantropy Hospital. Serological tests and imaging investigations were performed to establish the diagnosis and etiology. The first imaging impact was the echocardiogram, which revealed suggestive features of constrictive pericarditis, later confirmed through cardiac magnetic resonance imaging. Due to advanced symptoms, right heart failure phenomena, with hepatomegaly and grade 3 Lewis jugular vein distension, the initial treatment was with intravenous loop diuretics at a low dose and a sodium-glucose cotransporter-2 (SGLT2) inhibitor, but with poor tolerance due to a drop in blood pressure. For this reason, the patient was urgently referred to the Cardiovascular Surgery Department, where the case was resolved through pericardiectomy. The histopathological examination did not reveal a specific etiology as the cause of the constrictive pericarditis. The patient's postoperative evolution and paraclinical investigations showed a favorable status. Timely surgical intervention for this patient made the difference between symptom worsening and the potential onset of complications, and the successful resolution of the case.