A 55-year-old male from a rural village in sub-Saharan Africa presents to the clinic with progressive shortness of breath, fatigue, and swelling in his legs over the past 6 months. He reports that the symptoms started gradually and have worsened, particularly after exertion. He also mentions experiencing intermittent chest discomfort but denies any sharp or pleuritic pain. He has a history of multiple episodes of untreated acute pericarditis in the past, with no significant medical follow-up. The patient has had no known trauma or infections recently.

On physical examination, the patient appears dyspnoeic at rest with signs of right-sided heart failure, including bilateral lower extremity oedema, jugular venous distension, and hepatomegaly. His blood pressure is 110/70 mmHg, heart rate is 85 beats per minute, and respiratory rate is slightly elevated. A prominent pericardial knock is heard on auscultation. An ECG shows low voltage QRS complexes, and a chest X-ray reveals calcification of the pericardium. Echocardiography confirms the diagnosis of constrictive pericarditis, with thickened, non-compliant pericardium limiting diastolic filling of the heart.

The patient is referred for further evaluation, including potential surgical intervention, and is started on diuretics to manage the symptoms of heart failure. He is also advised to avoid strenuous activity and to follow up regularly with a cardiologist.