Background
Cardiac amyloidosis is an infiltrative cardiomyopathy characterized by restrictive physiology and progressive heart failure. Pericardial calcification is an extremely rare manifestation, reported in less than 1% of cases, and may mimic constrictive pericarditis, complicating diagnosis.
Case
A 60-year-old man with alcoholic liver disease, benign prostatic hyperplasia, and tobacco use presented with progressive dyspnea, abdominal distension, and anasarca. Exam revealed elevated jugular venous pressure and diffuse edema. Laboratory evaluation showed acute renal failure. Imaging demonstrated extensive calcifications of the pericardium and kidneys, an atypical finding for conventional causes of calcific pericarditis. Given multiorgan involvement, an infiltrative process was suspected. Biopsy confirmed AL amyloidosis.