Cholesterol Pericarditis: a Rare Case Report

Cholesterol pericarditis, or pericardial xanthoma, is a rare pericardial condition characterized by cholesterol crystal accumulation within the pericardium [1]. It is associated with hyperlipidemia, rheumatoid arthritis, hypothyroidism, and other cardiovascular risk factors [1], [2]. While the exact mechanisms remain unclear, chronic inflammation and lipid metabolism abnormalities are implicated [2]. This report describes the case of a 50-year-old female with hypercholesterolemia who presented with progressive dyspnea, chest pain, and fatigue. Diagnostic evaluation revealed massive pericardial effusion with cholesterol crystals but no infection or malignancy. The patient was successfully treated with pericardiocentesis, NSAIDs, and lipid-lowering therapy, achieving rapid symptom resolution. This case underscores the importance of considering cholesterol pericarditis in patients with unexplained pericardial effusion, especially those with dyslipidemia, and highlights effective management strategies for this rare condition.