Comprehensive Cardiopulmonary Rehabilitation in Constrictive Pericarditis with Pleural Effusion and Nutmeg Liver Disease: A Case Report

Constrictive Pericarditis (CP) is characterised by proliferation of granulation tissue within the pericardium, which reduces flexibility and causing right-sided heart congestion with impaired ventricular filling. The symptoms include chest pain, breathlessness, peripheral oedema and fatigue. The condition is rare, occurring in fewer than 1 in 10,000. In developed nations, 40 to 60% are idiopathic or due post-viral infection. Chronic venous hypertension can cause hepatic congestion, centrilobular necrosis, bridging fibrosis, and a “nutmeg liver” appearance of liver. Physiotherapy plays a vital role in management, incorporating breathing techniques, low to moderate intensity aerobic exercise, resistance training, and mobilisation to enhance recovery, strengthen respiratory muscles, and prevent deconditioning. A 33-year-old female presented with chest pain, back pain, dyspnoea {modified Medical Research Council (mMRC Grade III)}, cough, and fatigue. After medical management, supervised physiotherapy and supportive care, she showed improved lung function, and mobility. The present case highlights the importance of chest physiotherapy in pericarditis.