Journal of The Indian Academy of Echocardiography & Cardiovascular Imaging

INTERESTING IMAGES
Year
: 2019  |  Volume : 3  |  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

Correspondence Address:
Pankaj Jariwala
Department of Cardiology, CC Shroff Memorial Hospital, Barkatpura, Hyderabad - 500 001, Telangana
India




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;3:194-194


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 Jun 6 ];3:194-194
Available from: http://www.jiaecho.org/text.asp?2019/3/3/194/273303


Full Text

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.

[MULTIMEDIA:1]

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}

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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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.