A cursed duet—a case of tuberculous effusive-constrictive pericarditis

Figures

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  Fig. 1. Transthoracic echocardiogram (TTE) in an apical four-chamber view demonstrating a large circumferential pericardial effusion with maximum diameter of 37 mm

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  Fig. 2. Transthoracic echocardiogram (TTE) in parasternal short axis view at level of mitral valve demonstrating diastolic collapse of right ventricular free wall secondary to large compressive pericardial effusion

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  Fig. 3. Transthoracic echocardiogram in an apical four-chamber view with doppler at mitral valve demonstrating variation in mitral inflow velocities with respiration

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  Fig. 4. Transthoracic echocardiogram (TTE) in suprasternal view demonstrating exaggerated fall in systemic arterial flow velocities with inspiration—consistent with pulsus paradoxus

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  Fig. 5. Femoral pressure tracing (white) demonstrating respiratory variation (pulsus paradoxus)

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  Fig. 6. Right heart (orange) pressure tracing demonstrating elevated mean right atrial pressure and exaggerated ‘x’ descent

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  Fig. 7. Right atrial (orange) and intra-pericardial (white) pressure tracings pre-pericardiocentesis demonstrating elevated right atrial and intra-pericardial pressures

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  Fig. 8. Right atrial (orange) and intra-pericardial (white) pressure tracings post pericardiocentesis demonstrating normalisation of intra-pericardial pressure along with persistently raised right atrial pressure and steep right atrial ‘y’ descent

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  Fig. 9. Table comparing the features of cardiac tamponade, constrictive pericarditis and effusive constrictive pericarditis