Cor Vasa 2025, 67(Suppl.3):20-23 | DOI: 10.33678/cor.2025.018
Effusive-constrictive pericarditis following mild COVID-19: a case of combined surgical and medical therapy
- Cardiology Department, Unidade Local de Saúde da Região de Aveiro, Aveiro, Portugal
SARS-CoV-2 infection, initially perceived as a respiratory illness, is now recognized to cause cardiovascular complications, including rare cases of effusive-constrictive pericarditis. We present a case of a 45-year-old male who developed effusive-constrictive pericarditis following mild COVID-19. The patient was initially admitted with acute pericarditis and moderate pericardial effusion, treated with ibuprofen and colchicine. Two weeks later, he returned with worsening symptoms of heart failure, including orthopnea, edema, and fatigue. Echocardiography and cardiac magnetic resonance (CMR) revealed findings consistent with effusive-constrictive pericarditis and subacute myocarditis. Despite anti-inflammatory and diuretic therapy, symptoms persisted, necessitating pericardiectomy. The pericardium was severely thickened with extensive adhesions. Postoperatively, persistent heart failure symptoms and imaging findings of fibrotic pericardium led to initiation of corticosteroid therapy, which resolved symptoms. This case underscores the diagnostic and therapeutic challenges of effusive-constrictive pericarditis in the context of COVID-19. Non-invasive imaging, particularly CMR, was instrumental in identifying active pericardial inflammation and guiding treatment. While pericardiectomy remains a critical intervention in refractory cases, this case highlights the potential benefit of immunosuppressive therapy in resolving residual symptoms. Given the limited literature on COVID-19-associated pericarditis, multidisciplinary management is essential for optimizing outcomes and guiding future research.
Keywords: Constrictive pericarditis, COVID-19, Pericardial effusion
Received: January 5, 2025; Revised: January 5, 2025; Accepted: January 30, 2025; Prepublished online: June 2, 2012; Published: September 1, 2025 Show citation
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