title: Tuberculous Constrictive Pericarditis.
abstract: BACKGROUND
  Constrictive pericarditis is characterized by constriction of the heart secondary to pericardial inflammation. Cardiovascular magnetic resonance (CMR) imaging is useful imaging modality for addressing the challenges of confirming this diagnosis. It can be used to exclude other causes of right heart failure, such as pulmonary hypertension or myocardial infarction, determine whether the pericardium is causing constriction and differentiate it from restrictive cardiomyopathy, which also causes impaired cardiac filling.
  
  
  METHODS
  A 77-year-old man from a country with high incidence of tuberculosis presented with severe dyspnea. Echocardiography revealed a small left ventricle with normal systolic and mildly impaired diastolic function. Left heart catheterization revealed non-obstructive coronary disease, not felt contributory to the dyspnea. Anatomy imaging with cardiovascular magnetic resonance imaging (CMR) showed global, severely thickened pericardium. Short tau inversion recovery (STIR) sequences for detection of oedema/ inflammation showed increased signal intensity and free breathing sequences confirmed septal flattening on inspiration. Late gadolinium imaging confirmed enhancement in the pericardium, with all findings suggestive of pericardial inflammation and constriction.
  
  
  CONCLUSIONS
  CMR with STIR sequences, free breathing sequences and late gadolinium imaging can prove extremely useful for diagnosing constrictive pericarditis.
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK; School of Medicine, Imperial College London, London, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: Tse
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK.
authors.forename: Aamir
authors.initials: A
authors.lastname: Ali
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK.
authors.forename: Francisco
authors.initials: F
authors.lastname: Alpendurada
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Prasad
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK; School of Medicine, Imperial College London, London, UK.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Raphael
authors.affiliation: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London, UK.
authors.forename: Vassilis
authors.initials: V
authors.lastname: Vassiliou
keywords: Constrictive Pericarditides; Pericardial Effusion; Tuberculosis