Subacute Tuberculous Pericarditis With Fibroelastic Constriction Diagnosed Upon Pericardiectomy

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  • Ryoke Tsutomu
    Department of Cardiovascular Medicine, Konan Saint Hill Hospital
  • Kakukawa Hiroyuki
    Department of Cardiovascular Medicine, Konan Saint Hill Hospital
  • Kunichika Hideki
    Department of Cardiovascular Medicine, Konan Saint Hill Hospital
  • Nishimura Yuko
    Department of Cardiovascular Medicine, Konan Saint Hill Hospital
  • Sakai Hisanori
    Department of Cardiovascular Medicine, Konan Saint Hill Hospital
  • Minami Yoshihide
    Department of Cardiovascular Surgery, Konan Saint Hill Hospital
  • Fujii Takashi
    Second Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan
  • Matsuzaki Masunori
    Second Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Japan

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A patient with subacute pericarditis showed no evidence suggesting tuberculosis until pericardiectomy was performed because of hemodynamic deterioration. The excised pericardium had a rubbery fibroelastic consistency; histologically, there were granulomatous changes characteristic of tuberculosis. Although tuberculous pericarditis is a difficult diagnosis, this case illustrates the diagnostic and therapeutic importance of early pericardiectomy before myocardial inflammatory infiltration occurs together with end-stage pericardial fibrosis and calcification.

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