Calcific constrictive pericarditis

Case contributed by Subash Thapa
Diagnosis probable


Shortness of breath with on and off fever.

Patient Data

Age: 11 years
Gender: Male

Chest X-ray


Cardiac shadow is enlarged appearing rounded, globular appearance with no particular chamber enlargement. There is curvilinear radiodense shadow involving the antero-lateral margin of the cardiac border.

The lung field appears normal.

Case Discussion

Pericardial calcification in the setting of heart failure is highly suggestive of constrictive pericarditis

Calcification occurs among half of the patients with constrictive pericarditis; it often has a characteristic distribution involving the front and the lateral aspects of the heart but not at the back of the heart as fluid cannot collect around the insertion of the pulmonary veins 1.

Lungs are clear due to constriction over the right heart 1.

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