Primary malignant pericardial mesothelioma presenting as effusive-constrictive pericarditis

Effusive-constrictive pericarditis is a clinical hemodynamic syndrome characterized by constriction of the heart by the visceral pericardium in the presence of a tense pericardial effusion. The hallmark of effusive-constrictive pericarditis is the persistence of elevated right atrial pressures and ventricular interdependence after relief of the elevated intrapericardial pressures. The present report discusses the unique case of a 46-year-old white female who presented with dyspnea on exertion and chest tightness in the setting of an effusive-constrictive pericarditis. The patient was subsequently diagnosed with primary malignant pericardial mesothelioma, an extremely rare neoplasm with a very poor prognosis.