Tuberculous pericarditis

Tuberculous (TB) pericarditis has been common in South Africa for years and is increasing in Central and East Africa as a result of the HIV epidemic. Although less common in the developed world, it is seen occasionally. It is encountered increasingly in association with HIV infection and may be seen in immigrants. Tamponade from pericardial effusion is life-threatening, and constrictive pericarditis causes prolonged morbidity, but if recognized, TB pericarditis is curable and most patients are non-infectious. Often it is mistaken for myopathic heart disease, or even for non-cardiac disease; e.g. liver cirrhosis, hepatoma or nephrosis. Correct management depends on suspecting it by physical examination, confirming it by echocardiography, and proving it by culture.