case_images: PMC9112309_01
case_images: Transthoracic echocardiogram doppler imaging that shows the pathophysiology
  during expiration that causes decreased right ventricular filling and
  hepatic vein reversal during late diastole.
case_images: 10.1177_23247096221097530-fig1.jpg
case_images: PMC9112309_01_10.1177_23247096221097530-fig1.jpg
case_images: fig1-23247096221097530
case_images: In addition, it revealed several factors concerning for constrictive physiology including septal bounce, annulus reversus (mitral septal annular velocity = 0.16 m/s > mitral lateral annular velocity = 0.12 m/s), dilated, non-collapsible inferior vena cava, and biatrial enlargement with signs of ventricular interdependence and hepatic vein reversal (Figure 1).
case_images: Computed tomography (CT) of the heart revealed constrictive pericarditis with
  thick circumferential pericardial calcifications and a loculated anterior
  pericardial collection overlying and exerting mass effect on the right heart
  chambers.
case_images: 10.1177_23247096221097530-fig2.jpg
case_images: PMC9112309_01_10.1177_23247096221097530-fig2.jpg
case_images: fig2-23247096221097530
case_images: Dedicated computed tomography (CT) heart imaging confirmed the diagnosis of constrictive pericarditis (Figure 2) and demonstrated a large loculated pericardial collection exerting mass effect on the right heart chambers.
case_images: PMC9112309_02
case_images: Simultaneous right and left heart catheterization showing ventricular
  interdependence.
case_images: 10.1177_23247096221097530-fig3.jpg
case_images: PMC9112309_02_10.1177_23247096221097530-fig3.jpg
case_images: fig3-23247096221097530
case_images: The patient underwent cardiac catheterization, which demonstrated elevated left and right heart filling pressures, normal cardiac output and index, and simultaneous right and left ventricular pressures with interdependence, pressure equalization, and sharp y descents all consistent with constriction (Figure 3).