Calcific Constrictive Pericarditis

Dr.Jayanth KeshavamurthySagar Patel MS 3

HPI

Patient is 18-year-old white male who presented with fever, malaise, dark urine, and abdominal pain 6 weeks ago. Patient had hepatosplenomegaly on exam and elevated LFTs and hyperbilirubinemia. Patient tested positive for EBV IgM. Abdominal and pelvic CT for evaluation of abdominal pain showed incidental finding of pericardial calcifications warranting further workup.

Patient has been complaining of dyspnea on exertion and heart palpitations for the past few weeks.

Physical Exam

Neck: Bilateral jugular vein distention to just below the mandible noted while sitting upRespiratory: Lungs clear to auscultationCardiovascular: normal S1; physiologically split S2; no murmur, clicks, thrills, heave, or edema present; "Precordial knock" (early diastolic extracardiac sound) heard best at the apexGastrointestinal: liver 5cm distended; spleen 2cm distended

EKG

Echo

X-Ray PA

X-Ray Lat

CT Axial

CT Axial

CT Sagittal

CT Coronal

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