Constrictive pericarditis after SARS-CoV-2 vaccination: a case report and literature review

Constrictive pericarditis following SARS-CoV-2 vaccination is likely to be very rare and is characterized by a relatively severe clinical manifestation. We describe the case of a 42-year-old patient, without significant comorbidities, who developed perimyocarditis after the second dose of the COVID-19 vaccine. It was treated with nonsteroidal anti-inflammatory drugs. Six months after the perimyocarditis episode, the patient presented signs and symptoms of heart failure. A suspicion of constrictive pericarditis was raised. The diagnosis was confirmed by echocardiography, which showed typical signs of constriction, and cardiac CT, revealing a thickened pericardium with calcifications. Pericardiectomy with partial resection of the pericardium was indicated due to local significant adhesions between the pericardium and epicardium, which prevented total pericardiectomy. The procedure resulted in good hemodynamic and clinical outcomes.