CTICasesConstrictive Pericarditis
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Imaging findings
Chest radiography shows extensive, dense, plaque-like calcifications outlining the pericardium, along with associated pleural disease. Cardiac MRI demonstrates a pronounced, wiggling diastolic septal bounce (or "septal shimmy"), where the interventricular septum abruptly shifts toward the left ventricle during early diastole.
Key takeaways
Constrictive pericarditis is characterized by a rigid, often calcified pericardium that limits diastolic filling of the ventricles. On cardiac MRI, this manifests as a diastolic septal bounce, which represents a sudden pressure imbalance between the right and left ventricles during early diastolic filling, a highly sensitive sign for constriction that can be augmented during real-time imaging by asking the patient to inspire.
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