Heart in a Calcium Case: A Case of Constrictive Pericarditis

Abstract

A 71-year-old man with a 1.5-year history of worsening exertional dyspnea and fatigue presented to our clinic. On physical examination, cachexia, elevated jugular venous pressure, hepatomegaly, ascites, peripheral edema, and irregular pulses were notable. He did not have a history of tuberculosis, and a skin test for tuberculosis was negative. On electrocardiogram, low QRS voltage with atrial fibrillation rhythm was present. Chest roentgenogram showed cardiomegaly, widened carinal angle, and extensive pericardial calcification mostly localized on atrioventricular groove (Figure 1A).