Severe calcification in chronic constrictive pericarditis of tuberculous-related a case report and literature review

Fig. 1. ECG showing low voltage of QRS in peripheral leads and negative T waves from V1 to V6.

Fig. 2. Doppler echocardiography showing mitral inflow velocity with respiratory variation; Inspiration (blue arrow), Expiration (red arrow).

Fig. 3. Computed tomography demonstrates pericardial thickening (white arrow).

Fig. 4. Cardiac MRI shows pericardial thickening and calcifications mostly adjacent to the right ventricle.

Fig. 5. Intraoperative image showing pericardial thickeness and calcifications.

Fig. 6. Postoperative TTE showing regression of respiratory flow variation.

Fig. 7. Principal echocardiographic findings in constrictive pericarditis.(A) Leftward ventricular septal shift in inspiration (arrow). (B) Inspiratory decrease in early (E) inflow velocity (arrow) at Pulsed-wave Doppler. (C) Medial and (D) lateral mitral annular tissue Doppler recordings. Note (arrows) normal to increased early relaxation velocity (e’), with medial velocity slightly greater than lateral. (E) Pulsed-wave Doppler recording within the hepatic vein. Note prominent end-diastolic flow reversals with expiration (arrow) [14].

Fig. 8. Simultaneous left (Pink curve) and right (Blue curve) ventricular pressure tracings in constrictive pericarditis showing a Dip-plateau waveform (arrowhead) [17].