DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.096

Pages: 1262-1265

Background: Constrictive pericarditis (CP) is an uncommon but potentially reversible cause of chronic right heart failure. It results from fibrous thickening and calcification of the pericardium, which restricts diastolic ventricular filling. Timely diagnosis relies on multimodality imaging, as clinical presentation overlaps significantly with other causes of heart failure. Case Presentation: We report the case of a 45-year-old woman with no history of cardiac surgery, presenting with progressive dyspnea (NYHA class III) and clinical signs of right-sided heart failure, including jugular venous distension, hepatomegaly, and bilateral lower limb oedema. Chest radiography demonstrated dense, curvilinear pericardial calcifications outlining the cardiac silhouette associated with a large right pleural effusion. Non-contrast thoracic computed tomography (CT) confirmed diffuse circumferential pericardial thickening exceeding 4 mm, extensive calcifications predominantly along the right ventricular free wall and diaphragmatic surface, a large pericardial effusion, right atrial enlargement, and dilatation of the inferior vena cava and hepatic veins. The diagnosis of calcified constrictive pericarditis complicated by right heart failure was established. The patient was managed with intensive medical therapy and underwent surgical pericardiectomy. Conclusion: This case highlights the pivotal role of multimodality imaging — particularly chest radiography and CT — in the diagnosis and management of calcified constrictive pericarditis. Early recognition is essential to ensure timely surgical intervention and improve long-term patient outcomes.