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We present a 70\u2010year\u2010old male with a history of heart failure, atrial fibrillation (AF), cirrhosis, chronic obstructive pulmonary disease (COPD), and prior pleural effusion, who was admitted with acute hypoxic respiratory failure and AF with rapid ventricular response (RVR). Imaging revealed extensive pericardial calcifications, leading to a diagnosis of CCP. The patient\u2019s clinical course was marked by refractory hypotension, altered mental status, and progressive cardiohepatic syndrome. Given his high surgical risk, he was managed conservatively and transitioned to palliative care. This case underscores the diagnostic and therapeutic challenges of CCP, particularly in patients with complex comorbidities where surgical intervention is not feasible. It highlights the need for early recognition and individualized management strategies to optimize outcomes in this challenging subset of patients.<\/jats:p>","DOI":"10.1155\/cric\/5514172","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:34:09Z","timestamp":1746837249000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lessons From a Complex Case of Calcific Constrictive Pericarditis: A Case Report"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4978-5157","authenticated-orcid":false,"given":"Varun","family":"Kasula","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8684-6215","authenticated-orcid":false,"given":"Vikram","family":"Padala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5905-8456","authenticated-orcid":false,"given":"Jagroop","family":"Doad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Awais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod","family":"Chaubey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aditya","family":"Sood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Golden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"e_1_2_12_1_2","volume-title":"StatPearls","author":"Khalid N.","year":"2024"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-8703(99)70105-5"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2015.09.027"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-005-0238-6"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2017.07.007"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.08.032"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.61.02.184"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.11.021"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.cme.20.1.4"},{"key":"e_1_2_12_10_2","first-page":"553","article-title":"Acute Pericarditis: Diagnosis and Management","volume":"89","author":"Snyder M. 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