Localized Pericardial Constriction Resulting in a “Dumbbell” Heart

Constrictive pericarditis with a calcified pericardial band at the level of left ventricle causing mid-ventricular obstruction

“…Rarely, it can present with pericardial band causing localised constriction, and if such present, the constriction usually occurs at the AV level 7. Similar to constrictive pericarditis, constrictive pericarditis with pericardial band is a secondary condition preceded by an episode of acute pericarditis and time interval between these conditions may vary considerably.…”

Case Report: “Gourd-Shaped” Heart Strangled by Localized Annular Calcification of the Left Ventricle: A Rare Case of Constrictive Pericarditis

“…For patients with thickened and calcified pericardium, pericardiectomy is a potentially curable intervention that can improve prognosis. Most pericardial calcifications removed by pericardiectomy were found on the inferior and diaphragmatic surface, anterior right ventricular surface area, and atrioventricular groove posteriorly and over the infundibulum anteriorly (4,5). While a few cases of pericardial calcification in localized areas have not undergone surgery, lesions of fibrotic or calcified pericardium have been retained in situ (6)(7)(8).…”

Calcification ring in the atrioventricular groove

“…Sometimes it might simulate a mediastinal tumour and obstruct the right ventricular inflow tract 3. Localised constriction of the AV groove resulted in a ‘dumb-bell’ heart in one particular case 4. Rarely, it may cause coronary artery obstruction resulting in anginal symptoms 5.…”