What is a shelled heart?

In medicine, a shelled heart refers to a condition in which the heart is, as it were, encapsulated by calcification or hardening of the pericardium. The official medical term for this is constrictive pericarditis or calcified pericarditis.

Normally, the heart is enclosed in a thin, flexible membrane, the pericardium, which protects it and allows it to move as it contracts.

With a case of armored heart, the pericardium becomes inflamed due to infection, surgery, radiation, tuberculosis, etc. The membrane then hardens or calcifies, preventing the heart from expanding freely as it fills with blood. The heart then appears literally surrounded by a rigid shell, hence the name armored heart.

Because the heart can no longer expand properly, the blood supply and drainage are disrupted. Typical symptoms include * shortness of breath (especially during exertion), fluid retention in the legs or abdomen (edema, ascites), fatigue, swollen jugular veins, and a feeling of pressure in the chest.

Diagnosis is made with an ECG, cardiac ultrasound, CT, or MRI scan. These can reveal the thickened or calcified pericardial wall. In severe cases, a pericardectomy can be performed as treatment: the surgical removal of the hardened pericardium to give the heart space again.

Source: https://pubmed.ncbi.nlm.nih.gov/18762706/

Author: Prof. Dr. Dirk Devroey - Latest update: 2025-10-29 - Copyright: Clinifacts 2026