Mitral-annular Velocity Dynamics in CCP: Illustrating the Reversus-paradoxus Signs

摘要

Chronic constrictive pericarditis (CCP) is inherently associated with diastolic dysfunction. However, the relationship between: (1) Lateral to medial mitral annular velocity and (2) The ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e') to left atrial (LA) pressure is significantly altered in CCP.The present article highlights the same. A 26-year-old female had a history of pulmonary tuberculosis 3 years back and was treated with antitubercular drugs for 7 months. On completion of anti-tuberculosis therapy, she developed ascites, pedal edema, exercise intolerance,and orthopnea for 8-9 months. Extensive pericardial calcification was revealed on lateral chest X-ray. Two-dimensional transthoracic echocardiography (TTE) demonstrated pericardial effusion with thickened and calcified pericardium and dilated inferior vena cava with loss of respiratory variability. Subsequently, the patient was diagnosed with CCP and posted for pericardiectomy following medical optimization.