Chronic constrictive pericarditis with right ventricular outflow tract obstruction

Abstract

We present a case of a 62-year-old gentle man, who consulted us with a clinical diagnosis of constrictive pericarditis associated with a right ventricular outflow tract obstruction (RVOTO) murmur.Chronic constrictive pericarditis (CCP) is characterised by scarring of both the parietal and visceral pericardial layers covering both the ventricular chambers. Generalised constriction is the usual rule with CCP but localised form can occur.1 Localised pericardial constriction should be considered in patients, who present with re-constriction following previous partial pericardiectomy. Localised constriction when present in the isolated form mimics other cardiac conditions such as valvular stenosis, especially when the usual signs of generalised constriction are lacking.Trans-thoracic echocardiography, CT chest and angio-cardiography demonstrated CCP with thick pericardium and an organised pericardial collection with calcification, compressing RVOT. Since the usual clinical and investigatory findings of constrictive pericarditis were evident in addition to the features of localised constriction as manifested by RVOT obstruction, a diagnosis of CCP with RVOT obstruction was prompt in our case.

Keywords

• Constrictive pericarditis
• Murmur
• RVOT obstruction