John Mauceri had a complicated health history, but his sudden swelling and fatigue left his team of doctors stumped.
A Mysterious Medical Journey
Acclaimed conductor John Mauceri was no stranger to health challenges. At 78, he had already navigated diagnoses of psoriatic arthritis in 2017, followed by chronic lymphocytic leukemia and interstitial lung disease in 2019. Though medication had successfully treated these conditions and sent his cancer into remission, his medical journey was far from over.
In December 2023, Mauceri contracted COVID-19, which left him struggling to climb stairs and dealing with a persistent cough. An emergency room visit at NYU Langone revealed viral pneumonia and severe lung disease, requiring the removal of three liters of liquid from his right lung. After about a week of hospitalization, he was discharged, seemingly on the path to recovery.
However, alarming new symptoms rapidly emerged. First, his left ankle began to swell inexplicably. Then the swelling progressed upward through his leg, eventually spreading to his abdomen and down his right leg as well. At the height of this mysterious condition, Mauceri was gaining approximately one pound every day.
"I was wearing somebody else's body, at least from my waist down," Mauceri recalled. "I couldn't wear normal clothes. Putting shoes on was hard. I couldn't walk through my house."
Despite having assembled a comprehensive medical team—including an oncologist, pulmonologist, and rheumatologist—no one could identify what was causing his dramatic symptoms. "I had a lot of doctors, and they all thought it was somebody else's domain," Mauceri explained.
The Search for Answers
Dr. Adam Skolnick, a cardiologist at NYU Langone and one of Mauceri's physicians, initially investigated common causes for such swelling. Mauceri underwent MRIs and other tests, which confirmed his lymph system was functioning normally. Cardiac catheterization found no signs of heart disease, and there were no indications of blood clots, cancer recurrence, or other typical conditions.
Meanwhile, the swelling continued to strain Mauceri's body, putting him at risk of multi-organ failure. Through careful study of Mauceri's heart images, Dr. Skolnick began developing a theory, but confirming it would require an invasive procedure.
"The only definitive way to fully diagnose and treat Mr. Mauceri would be through surgery to open the chest," Dr. Skolnick explained.
His suspicion was pericardial constriction, a rare condition where the sac surrounding the heart (pericardium) becomes thickened by scarring, preventing the heart from fully expanding. This restriction creates pressure that results in swelling throughout the lower body. The condition is often acquired following a viral illness such as COVID-19.
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