This 31 y/o male developed abdominal pain and dyspnea on exertion. Selected images from an abdominal CT shown above demonstrate calcific pericarditis. Additionally, there is irregularity of the ventricular outline and the inferior vena cava is markedly enlarged consistent with constrictive pericarditis. Cardiac catheterization revealed equalization of pressures in the cardiac chambers. The patient experienced relief of symptoms after pericardiectomy. An etiology for the calcific pericarditis was never firmly established.