|Year : 2019 | Volume
| Issue : 3 | Page : 194
Tuberculous Constrictive Pericarditis with Pericardial Calcification – An Antique Picture
Pankaj Jariwala1, Kuchukulla Venkatram Reddy2
1 Department of Cardiology, CC Shroff Memorial Hospital, Hyderabad, Telangana, India
2 Department of Radio Diagnosis, CC Shroff Memorial Hospital, Hyderabad, Telangana, India
|Date of Submission||10-Feb-2019|
|Date of Acceptance||22-Feb-2019|
|Date of Web Publication||18-Dec-2019|
Department of Cardiology, CC Shroff Memorial Hospital, Barkatpura, Hyderabad - 500 001, Telangana
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jariwala P, Reddy KV. Tuberculous Constrictive Pericarditis with Pericardial Calcification – An Antique Picture. J Indian Acad Echocardiogr Cardiovasc Imaging 2019;3:194
|How to cite this URL:|
Jariwala P, Reddy KV. Tuberculous Constrictive Pericarditis with Pericardial Calcification – An Antique Picture. J Indian Acad Echocardiogr Cardiovasc Imaging [serial online] 2019 [cited 2020 Jan 26];3:194. Available from: http://www.jiaecho.org/text.asp?2019/3/3/194/273303
A 42-year-old female with a remote history of pulmonary tuberculosis treated partially with antituberculous therapy complained of progressive breathlessness on exertion developed over a period of 6 months. On examination, her vitals were normal. Distension of the jugular venous vein and elevation of jugular venous pressure, particularly during inspiration with prominent “x” and “y” descents – suggestive of Kussmaul's sign was observed [Video 1]. Heart sounds were normal and there was no murmur but a high pitch pericardial knock coinciding with the nadir of “y” descent was heard. Her laboratory parameters were normal.
Chest X-ray showed an eggshell calcification of pericardium [Figure 1]a. Echocardiography revealed ventricular septal motion abnormality (M-mode), hepatic vein expiratory diastolic reversal ratio ≥0.79 (pulse-wave Doppler), and plethoric inferior vena cava, which are the most characteristic features of constrictive pericarditis.
|Figure 1: Chest X-ray showing pericardial calcification of the atrium-ventricular groove (a) and computed tomography of the chest at the level of mid ventricle showing patchy calcification, which is classical feature of tuberculosis (b, arrows)|
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High-resolution computed tomography of the chest showed thickened pericardium with patchy calcification, mostly in the anterolateral aspect, which is a characteristic of tuberculous pericarditis [white arrows, [Figure 1]b. After confirmation of the diagnosis, she underwent pericardiectomy with relief of her symptoms during follow-up.
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