IntroductionEffusive constrictive pericarditis (ECP) is a unique clinical syndrome that is characterized by the coexistence of pericardial effusion and constrictive pericardium. The etiology of ECP usually contains tuberculosis, idiopathic, and neoplastic causes. The early diagnosis, treatment strategy and prognostic predictor of ECP still remain a big problem nowadays due to the sophisticated clinical situations. Case PresentationWe here report a rare case of idiopathic ECP with thickened adherent visceral pericardium and normal parietal pericardium, accompanying multiple complications mainly comprising severe tricuspid regurgitation, hypoproteinemia, and proximal deep venous thrombosis. The patient was referred for radical pericardiectomy successfully, but the long-term prognosis may be unfavorable. DiscussionThis case aims to provide some clinical experience of such situation in which the clinician should weight the benefits and the risks to a particular patient.