Biventricular Failure due to Stress Cardiomyopathy after Pericardiectomy for Constrictive Pericarditis
Figure 1
Imaging findings consistent with constriction. Initial transthoracic echocardiography shows Doppler spectral revealing a presystolic flow (white arrow) through the pulmonic valve due to premature opening of the valve (a), exaggerated respiratory variation of the mitral valve inflow (b), an apical 3-chamber view of the thickened pericardium (outlined by arrows) around the inferolateral/posterior wall of the left ventricle (c), and exaggerated left ventricular outflow tract flow variation (arrows) (d). Cardiac CT with contrast demonstrates axial (e) and coronal (f) images of the markedly thickened pericardium measuring 13.4 mm and pleural effusion. Cardiac MR also demonstrates the thickened pericardium in the T2-weighted bright blood imaging (g) and the intense late gadolinium enhancement of the pericardium without myocardial involvement (h).
