The ‘napkin-ring’ constrictive pericarditis

A 77-year-old male was diagnosed in 1997 with constrictive pericarditis after a severe chest trauma with diaphragm injury, sternum fracture and chest empyema that eventually required drainage and decortication of the left pleura. The clinical course was favorable, as he remained in NYHA class II state for 18 years receiving only medical therapy. During the last year, he developed clinical signs of right heart failure and became unresponsive to increasing doses of diuretics. Therefore, he was referred for a repeat …