Tuberculous constrictive pericarditis: challenges and surgical management

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.