Presentation
Heart failure.
Patient Data

A geographic box-shaped area of calcification is projected over the heart.
Pulmonary vascular markings are mildly prominent.
Healed fractures of the right 4th-8th ribs laterally.
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Thick pericardial calcification is evident.
Prominent ascending aorta and tortuous descending aorta.
Case Discussion
The patient underwent pericardiectomy in an attempt to improve cardiac function.
The cause for pericardial calcification remained unknown.
The patient had a distant history of abdominal tuberculosis. He also had a history of prior trauma with right-sided rib fractures - possible hemopericardium at the time? Both are potential causes.
There was no history of cardiac disease or cardiac surgery.