A case of constrictive pericarditis diagnosed for hypotension occurring after two years on hemodialysis

One of the most frequently encountered dialysis-related complications is hemodialysis-associated hypotension. In this case, we encountered a patient with a 2-year history of dialysis, where the cause of hemodialysis-associated hypotension was constrictive pericarditis (CP). CP is a rare condition, and diagnosis is often challenging, making early detection and treatment crucial for patient outcomes. At the time, despite clinical signs of right heart failure, echocardiographic findings did not suggest heart failure, making the diagnosis difficult. Based on physical findings, further investigation into conditions causing right heart failure revealed pericardial thickening, leading to suspicion of CP. A right heart catheterization confirmed the diagnosis of CP, and the patient underwent pericardiectomy, which resulted in an improvement in dialysis-related complications. This case underscores the importance of considering CP as a potential cause of dialysis-related complications and highlights the need for a comprehensive diagnostic approach grounded in physical examination.