MediAI

  Executive Clinical Summary A man in his late 60s presented with progressive heart failure symptoms over two years, including severe lower extremity edema, dyspnea, and repeated decompensation. Physical examination revealed jugular venous distention and Kussmaul sign. Imaging demonstrated extensive pericardial calcification with pericardial thickening (~6 mm) and bilateral pleural effusion. This case illustrates a classic yet frequently delayed diagnosis: constrictive pericarditis , where the pathology lies not in myocardial failure but in a rigid, noncompliant pericardium that restricts diastolic filling. Key Clinical Questions Why can constrictive pericarditis mimic advanced heart failure? What imaging findings are most diagnostic? How can CT, echocardiography, and MRI be integrated? When should pericardiectomy be considered? Clinical Hook A patient repeatedly treated for heart failure continues to deteriorate. Diuretics provide only temporary relief. The edema...