Case Report

A difficult diagnosis - constrictive pericarditis and its treatment: a case report

Harith A Altemimi¹ , Syed Y Altaf¹ , Rhian K James² , Rajah Nata¹ , Eshwar B Kumar¹ and Max Codispoti³

¹  Department of Cardiology, The Queen Elizabeth Hospital NHS Trust, Kings Lynn, PE30 4ET, UK

²  University of Cambridge School of Clinical Medicine, Addenbrooke's Biomedical Campus, Cambridge, CB2 0SP, UK

³  Department of Cardiothoracic Surgery, Papworth Hospital NHS Foundation Trust, Papworth Everard Cambridge CB23 3RE, UK

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Cases Journal 2009, 2:9105doi:10.1186/1757-1626-2-9105

Published:	28 November 2009

Abstract

The diagnosis of constrictive pericarditis requires a high degree of clinical suspicion, for the signs and symptoms of this disease can be falsely attributed to other causes. Herein, we present a case of a 70-year old retired farmer whose symptoms of right heart failure were initially attributed to co-existing pneumonia and pulmonary embolism. He was discharged. Three weeks later he presented with worsening breathlessness and ascites. Echocardiography, computed tomography and cardiac catheterization revealed the diagnosis of constrictive pericarditis. He underwent complete pericardectomy and to date has made a good recovery. This case exemplifies the difficulty in diagnosing this condition, the investigation required, and provides a discussion of the benefit and outcomes of prompt treatment.