Picture Perfect Constrictive Pericarditis: A Case Report

Abstract Background Constrictive pericarditis (CP) is a rare complication of acute pericarditis, caused by pericardial fibrosis and calcification that impair diastolic filling. It leads to right-sided heart failure and requires multimodal imaging for diagnosis, including echocardiography, cardiac MRI, and right heart catheterization. Case Presentation A 75-year-old male with a recent history of pneumonia and chest pain presented with dyspnea and edema. Echocardiography showed a septal bounce; CT revealed pericardial calcification; and right heart catheterization demonstrated equalized diastolic pressures with a square root sign. MRI confirmed CP. The patient was managed medically and referred for pericardiectomy. Discussion This case illustrates classic CP with hallmark clinical, imaging, and hemodynamic findings. It emphasizes the diagnostic value of multimodal evaluation and serves as a comprehensive example of this uncommon but critical condition.