Pericardial tuberculosis
ICD-10 A18.8ICD-11 1B12.0

Tuberculous Pericarditis Presenting as Effusive-Constrictive Pericarditis

Clinical scenario

Tuberculous pericarditis can manifest in distinct clinical forms. This protocol addresses the combined effusive-constrictive presentation — a pattern characterised by simultaneous pericardial fluid and constrictive haemodynamic features, which poses specific diagnostic and management challenges.

Presentation

Tuberculous pericarditis presents clinically in three recognised forms: pericardial effusion, constrictive pericarditis, and a combined form — effusion together with constriction. The effusive-constrictive variant is the focus of this protocol.

Treatment approach

Management involves antituberculosis therapy alongside serial monitoring for structural changes in the pericardium. When a specific structural change develops, a surgical intervention targeting the pericardial wall becomes the key next step — the full structured algorithm specifying indications, sequencing, and monitoring criteria is available via the protocol.

References
DOI: 10.1161/circulationaha.105.543066
Tuberculous pericarditis presents clinically in 3 forms, namely, pericardial effusion, constrictive pericarditis, and a combination of effusion and constriction.
Antituberculosis drugs should be given and serial echocardiography performed to detect the development of a pericardial skin that is amenable to surgical stripping.
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