PDC-Answers |

*Dhruv Bansal, **Priya Bansal

*Resident, Department of Medicine, Lady Hardinge Medical College, New Delhi

**Professor, Department of Medicine, Lady Hardinge Medical College, New Delhi

Answers

Figure 1 – X-ray of the chest showing pericardial calcification encasing the heart.

Figure 2 – Computed tomography scan of the chest (coronal view) showing hyperdense white strands of calcific pericardium.

Figure 3 – Computed tomography scan of the chest showing four chamber view of the heart with enlargement of left and right atria along with disproportionately shrunken right ventricle.

Case summary

A 46-year-old female with a past history of tuberculous ascites 3 years back (took antitubercular treatment for 8 months) presented with gradually progressive abdominal distension and dyspnea for 3 months. Physical examination revealed elevated jugular venous pressure (Kussmaul sign positive), bilateral pitting pedal edema and fluid thrill on abdominal percussion.

X-ray, computed tomography and two-dimensional echocardiography showed findings consistent with constrictive pericarditis.

The patient was labelled with the final diagnosis of “Tuberculous Calcific Constrictive pericarditis