Case Session 03: Pericardial Disease (2018)-Tuberculous Pericarditis. From overt pathology to healing. Insights from CMR

Tuberculous Pericarditis. From overt pathology to healing. Insights from CMR

Video Transcription

Video Summary

A 35-year-old man from Senegal presented with two months of dyspnea, fever, abdominal pain, weight loss, and signs of right heart failure. Workup showed cardiomegaly, anemia, elevated transaminases, positive Mantoux, and imaging evidence of a thick pericardial mass causing constrictive physiology. Cardiac MRI suggested an infiltrative pericardial process. Pericardial biopsy via mini-thoracotomy revealed necrotizing granulomas, and microbiology confirmed Mycobacterium tuberculosis, diagnosing tuberculous pericarditis. After anti-tuberculous treatment, his symptoms resolved, constrictive signs disappeared, and follow-up MRI showed near-complete resolution. The case highlights the importance of considering tuberculosis in pericardial masses and the value of cardiac MRI and biopsy.

Keywords

tuberculous pericarditis

Mycobacterium tuberculosis

constrictive pericarditis

cardiac MRI

pericardial biopsy