Severe Calcific Constrictive Pericarditis From Remotely Treated Tuberculosis

Background: Constrictive pericarditis from tuberculosis is a rare but serious consequence of a tuberculosis infection, especially in nonendemic areas. Case Summary: A 40-year-old man with a history of tuberculosis as a child that was treated with antituberculosis medications presented with heart failure. He was found to have severe calcific constrictive pericarditis from his remote tuberculosis infection, leading to biventricular failure and volume overload. The patient was optimized with guideline-directed medical therapy and intravenous diuresis, and he successfully underwent pericardiectomy with marked improvement in symptoms and quality of life. Discussion: We present a rare case of severe calcific constrictive pericarditis that manifested clinically decades after the initial tuberculosis infection. Multimodality imaging, which includes echocardiography, cardiac computed tomography, and cardiac magnetic resonance, is valuable for diagnosing and guiding treatment for constrictive pericarditis.