%0 Journal Article
%A De Agustín Loeches, José Alberto
%A Álvarez, Jordi
%A García, Ángel
%A González Ferrer, Juan José
%A Núñez Gil, Iván Javier
%A Marcos Alberca, Pedro
%A Fernández Golfín, Covadonga
%A Macaya Miguel, Carlos
%A Zamorano Gómez, José Luis
%T Subacute tuberculous constrictive pericarditis
%D 2012
%@ 0735-1097
%U https://hdl.handle.net/20.500.14352/131937
%X A 22-year-old man was admitted to the hospital with progressively worsening exertional dyspnea, thoracic pain, and low-grade evening fever. Transthoracic echocardiography revealed a thick fibrinous exudate in the pericardial sac (A) associated with diminished movements of the heart surface and septal bouncing ( B , Online Videos 1 and 2 ). An exaggerated inspiratory expansion of the right ventricle and simultaneous compression of the left ventricle were noticed ( Online Video 3 ). Doppler echocardiography reported large respiratory variations in ventricular filling and aortic flow (C, D) . Also, increased suprahepatic vein flow reversal with expiration was detected (E) . Cardiac magnetic resonance was performed and showed generalized pericardial thickening involving both parietal and visceral pericardium, with maximal thickness of 20 mm (F) . Contrast-enhanced imaging showed prominent delayed hyperenhancement at the pericardium (G) . The patient had strongly positive tuberculin test results, and a biopsy of a mediastinal adenopathy was performed. Histopathologic examination showed severe inflammation with granulomas, consistent with tuberculosis (H) .
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