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A 66-year-old man was evaluated for recurrent cardiac decompensation and a 2-year history of worsening heart failure. Physical examination revealed distention of the jugular vein with Kussmaul's sign, spider nevi, and bilateral leg edema. New York Heart Association class IV heart failure was diagnosed. He had had pulmonary tuberculosis approximately 60 years earlier. Chest radiography revealed severe calcification of the pericardium (thickness, 6 mm) (arrow, Panel A), and computed tomography revealed bilateral pleural effusion (arrows, Panel B). Fluoroscopy and echocardiography confirmed the diagnosis of severe constrictive pericarditis with only a small anterior region of the pericardium free of calcification. Left . . . [Full Text of this Article] |
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