Constrictive Pericarditis

Figure 1. Progressive cardiac failure developed during a viral illness in a 76-year-old woman. Examination revealed marked jugular-vein distention with Kussmaul's sign, edema of the legs, and a pericardial knock. A chest film showed mild cardiac enlargement and extensive calcifications on the anterior and inferior surfaces of the heart involving both layers of pericardium. Gated, T 1 -weighted, spin–echo magnetic resonance images of the heart in the transverse axial view (Panel A) and oblique sagittal view (Panel B) showed diffuse thickening of the entire pericardium, calcifications (arrows in Panel A), right atrial (RA) enlargement, a moderate amount of fluid between . . .