Background
Constrictive pericarditis is a disease characterized by inflammation, fibrosis and loss of elasticity of the pericardium, leading to restricted ventricular filling and diastolic dysfunction. Consequently, there is an increase in ventricular interdependence and dissociation of intracardiac and intrathoracic pressures during ventilation. Clinically, insidious signs and symptoms of venous congestion, predominantly systemic, appear. It is a relatively rare condition, with varied causes [1,2]. Tuberculous pericarditis is an uncommon cause of pericarditis in developed countries but may account for up to 30% of pericarditis cases in endemic countries [3]. Progression to constrictive pericarditis is reported in up to 30% of cases of tuberculous pericarditis [4]. Pericardiectomy is the standard treatment for patients with symptomatic constrictive pericarditis [5]. However, an intrinsic risk to surgery is right ventricle (RV) dysfunction, a consequence of myocardial atrophy [6] and the abrupt increase in venous return that lead to volume overload, mainly in the RV. Echocardiography is an effective method to monitor these post-pericardiectomy hemodynamic changes.
We report the case of a 41-year-old male patient who developed new RV dysfunction two weeks after pericardiectomy for tuberculous constrictive pericarditis.