Constrictive Pericarditis with Caseous Necrosis: A Rare and Underrecognized Presentation

Abstract

Caseous necrosis of the mitral valve is the term used to describe the liquefaction of calcium present in its fibrous ring and the consequent formation of a pseudotumor with a thick, pasty content within. Although rare, this degenerative process has been widely described in the context of the mitral valve; however, it is little known in the context of constrictive pericarditis. We describe a series of seven cases that presented with constrictive pericarditis associated with caseous necrosis. Of the seven patients, six were male, with a mean age of 42±14 years, all in functional class III/IV, with clinical signs related to restrictive syndrome. Chest tomography showed intense pericardial calcification with caseous necrosis, confirmed by pericardiectomy.