A patient presented with chronic constrictive pericarditis, ascites, hepatomegaly, pedal edema, congestive cardiac failure, and was probably tubercular in etiology. An echocardiogram showed pericardial thickening, diastolic dysfunction of both ventricles, increased respiratory variation of early diastolic velocities, dilated and non-collapsible IVC, increased hepatic doppler flow reversal, elevated PA pressure, severe TR, and diastolic collapse of the RV. The echocardiogram confirmed the diagnosis of chronic constrictive pericarditis.

1. Case Presentation
CCP

2. Clinical
Diagnosis
• Chronic Constrictive Pericarditis, Ascites,
Hepatomegaly, Pedal Edema, CCF, Probably
tubercular etiology, NSR, NYHA Grade III, on
ATT,

3. Chest X Ray

4. ECG

5. Echocardiography

6. Echocardiography

7. Echocardiography

8. Echocardiography

9. Echocardiography report
• Chronic Constrictive Pericarditis
• Pericardial thickening present – 5mm
• No pericardial effusion
• Diastolic Dysfunction grade (Biventricular) III
• Increased respiratory variation of early diastolic velocity across mitral valve (>25%), Annulus paradoxus
• Increased respiratory variation of early diastolic velocity across tricuspid valve (>40%)
• IVC Dilated and non collapsible
• Increased hepatic doppler flow reversal during expiration
• PA pressure across valve -30 mm HG
• Severe TR, Other Valves Normal
• Intact IAS/IVS
• Septal Bounce +nt
• Diastolic Collapse of RV present
• Normal LV function