Focal constrictive pericarditis, an unusual cause for biventricular failure

A 34 year old male who had undergone surgical closure of a ventricular septal defect at the age of 4 years, after a long asymptomatic period, presented with heart failure and was diagnosed with atrial flutter and biventricular dysfunction. Chest X-ray showed a band-like calcification in the atrioventricular groove. Echocardiography revealed dilated atria, focal calcification with constriction at the atrioventricular groove, and biventricular systolic dysfunction. Focal constrictive pericarditis occurring in post-cardiac surgery patients is very rare. Here we report a case of focal variant of constrictive pericarditis manifesting in a young male after 3 decades of ventricular septal defect repair.