Propionibacterium acnes: A Treatable Cause of Constrictive Pericarditis

Figure 1

(a), (b) Transthoracic echocardiogram (apical (a) and parasternal short-axis (b)) before pericardiocentesis: two large, loculated pericardial effusions (blue arrows) are noted with significant indentations of the right and left ventricular free wall. (c) Pulsed-wave Doppler interrogation of mitral valve inflow on transthoracic echocardiogram: evidence of significant (>25%) reduction in mitral valve E velocity (orange arrows) consistent with constrictive physiology after pericardiocentesis. (d) Cardiac magnetic resonance imaging following gadolinium administration revealed diffuse pericardial thickening and delayed enhancement (yellow arrows) after pericardiocentesis.

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