A Case of Acute Pericarditis With Moderate Pericardial Effusion in a Medically Complex, Bedbound Elderly Patient

Pericarditis is an inflammatory condition of the pericardium that often presents with chest pain and is diagnosed based on characteristic clinical, electrocardiographic, and imaging findings. We present the case of a 74-year-old female patient with significant comorbidities, including morbid obesity, functional quadriplegia, chronic venous stasis, chronic deep vein thrombosis on anticoagulation, and recent cholecystostomy tube placement, who developed acute pericarditis with a moderate pericardial effusion. Despite initial electrocardiographic findings concerning for acute coronary syndrome, serial cardiac biomarkers were negative, and imaging confirmed pericardial inflammation without tamponade physiology. The patient was successfully managed with non-steroidal anti-inflammatory drugs and colchicine, with improvement in symptoms. This case highlights the diagnostic challenges of pericarditis in medically complex patients and emphasizes contemporary guideline-directed management, risk stratification, and multidisciplinary care coordination.