Chigullapalli Sridevi, Malani Susheel Kumar, Jadhav Ajitkumar Krishna, Bhandari Rohit
Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India.
Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
BMJ Case Rep. 2025 Sep 5;18(9):e265263. doi: 10.1136/bcr-2025-265263.
Constrictive pericarditis is a condition in which inflammation of the pericardium results in the loss of pericardial elasticity, leading to restricted ventricular filling. This case reports a male in his 50s who presented with symptoms of bilateral pedal oedema and dyspnoea. Examination revealed a raised jugular venous pulse, abdominal dullness and crepitations in both lungs. Echocardiography and cardiac computed tomography revealed the characteristic features of chronic constrictive pericarditis, including septal involvement, calcific deposits and right-sided heart failure. The patient was also diagnosed with chronic liver cirrhosis. The patient underwent a surgical pericardiectomy. Histopathological examination of the pericardial tissue confirmed a tuberculous aetiology. The patient was postoperatively managed for heart failure and antitubercular medication and was subsequently discharged. The patient was readmitted with symptoms of right-sided heart failure and eventually died. This case highlights that constrictive pericarditis with myocardial involvement has poor outcomes after intervention, emphasising the need for early diagnosis.
缩窄性心包炎是一种心包炎症导致心包弹性丧失，进而引起心室充盈受限的病症。本病例报告了一名50多岁的男性，他出现双侧足部水肿和呼吸困难的症状。检查发现颈静脉压升高、腹部叩诊浊音以及双肺湿啰音。超声心动图和心脏计算机断层扫描显示了慢性缩窄性心包炎的特征性表现，包括间隔受累、钙化沉积和右侧心力衰竭。该患者还被诊断为慢性肝硬化。患者接受了心包切除术。心包组织的组织病理学检查证实病因是结核。患者术后接受心力衰竭治疗和抗结核药物治疗，随后出院。患者因右侧心力衰竭症状再次入院，最终死亡。本病例强调，伴有心肌受累的缩窄性心包炎在干预后预后较差，凸显了早期诊断的必要性。
