Cardiac MRI in the evaluation of pericardial and myocardial involvement in tuberculosis with 2 case reports

BABU PETER SATHYANATHAN; RAGHU NANDHAN

doi:10.5455/ajdi.20210107023143

Abstract
Tuberculosis caused by Mycobacterium Tuberculosis, is a major health care problem in India. While pulmonary manifestations are well characterized, cardiac tuberculosis is rare. It is estimated that 1% of all cases of Tuberculosis have cardiac involvement . We present a case series of two cases of Pericardial Tuberculosis presenting as Pericardial thickening with nodular mass mimicking Lymphoma and another case of Tuberculosis presenting as Myocarditis with concomitant lymphadenopathy . Cardiac MRI will be a problem solving tool in differentiating the unusual cardiac masses. It offers several advantages over echocardiogram in that detailed anatomical extent as well as simultaneous detection of concomitant chest abnormalities can be done . Parametric mapping and delayed contrast imaging enable detection of myocardial edema and fibrosis. A high index of suspicion needed to detect Pericardial and Myocardial Tuberculosis . In view of patient morbidity and mortality, prompt recognition and early diagnosis of potentially treatable Cardiac Tuberculosis is essential.

Key words: Cardiac Tuberculosis, Pericardial TB, Myocardial TB, Constrictive Pericarditis, Post Contrast Imaging, Native T1 Mapping.