Calcific Constrictive Tuberculous Pericarditis in Pregnancy: A Shared Decision-Making Approach.

BACKGROUND: Calcific constrictive tuberculous pericarditis is rare in the United States and even more uncommon in pregnancy, but it carries significant morbidity and requires individualized, multidisciplinary counseling.

CASE SUMMARY: A 40-year-old woman with a history of tuberculosis presented at 16 weeks' gestation with symptomatic calcified constrictive pericarditis. Despite medical management, she developed progressive hemodynamic compromise. Given her ongoing symptoms and preference to avoid pericardiectomy, she elected for second-trimester termination after shared decision-making.

DISCUSSION: Calcific constrictive pericarditis in pregnancy is exceedingly rare, with few reported cases and variable maternal-fetal outcomes. This case is to our knowledge the first to describe pregnancy termination as part of individualized, multidisciplinary counseling for calcific constrictive pericarditis.

TAKE-HOME MESSAGE: In calcific constrictive pericarditis with hemodynamic compromise, pregnancy termination may be considered a therapeutic option when pericardiectomy is contraindicated or declined.