Pericardial calcification may occur secondary to a wide variety of inflammatory insults ranging from viral infections, uraemia, and pericarditis, which usually result in a thinner, eggshell pattern of calcification, compared to more aggressive inflammatory conditions such as TB, in which thick, confluent, and irregular calcification may be seen.

The presence of pericardial calcification is not diagnostic of constrictive pericarditis and may be an asymptomatic incidental finding. However, in this case, the clinical features and IVC dilatation are in keeping with significant cardiac constriction. Constrictive pericarditis is often misdiagnosed as liver disease.

The normal pericardial thickness on the CT scan should be less than 2 mm ¹.