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Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 194

Tuberculous Constrictive Pericarditis with Pericardial Calcification – An Antique Picture


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 Submission10-Feb-2019
Date of Acceptance22-Feb-2019
Date of Web Publication18-Dec-2019

Correspondence Address:
Pankaj Jariwala
Department of Cardiology, CC Shroff Memorial Hospital, Barkatpura, Hyderabad - 500 001, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiae.jiae_6_19

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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 Jul 10];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.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


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