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De Agustín Loeches, José Alberto Álvarez, Jordi García, Ángel González Ferrer, Juan José Núñez Gil, Iván Javier Marcos Alberca, Pedro Fernández Golfín, Covadonga Macaya Miguel, Carlos Zamorano Gómez, José Luis 2026-02-09T13:50:57Z 2026-02-09T13:50:57Z 2012-11-01 De Agustín, J. A., Álvarez, J., García, A., González-Ferrer, J. J., Núñez-Gil, I. J., Marcos-Alberca, P., Fernández-Golfín, C., Macaya, C., & Zamorano, J. (2012). Subacute tuberculous constrictive pericarditis. Journal of the American College of Cardiology, 59(11), e21. https://doi.org/10.1016/j.jacc.2011.07.059 0735-1097 10.1016/J.JACC.2011.07.059 https://hdl.handle.net/20.500.14352/131937 https://doi.org/10.1016/J.JACC.2011.07.059 https://www.jacc.org/doi/10.1016/j.jacc.2011.07.059 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) . eng restricted access Subacute tuberculous constrictive pericarditis journal article