Tuberculous constrictive pericarditis diagnosed by cardiac magnetic resonance imaging: A case report

RATIONALE: Constrictive pericarditis (CP) is a diagnostic challenge due to its nonspecific and insidious presentation. PATIENT CONCERNS: A 38-year-old man presented with bilateral lower limb edema and exertional dyspnea. DIAGNOSES: Cardiac magnetic resonance imaging demonstrated pericardial thickening, late gadolinium enhancement, and interventricular septal bounce. Tuberculous CP was considered based on imaging findings, positive interferon-gamma release assay, therapeutic response, and epidemiologic background. INTERVENTIONS: The patient was treated with anti-tuberculosis therapy without surgical pericardiectomy. OUTCOMES: Follow-up imaging showed near-complete resolution of pericardial thickening and effusion, with sustained clinical improvement. LESSONS: This case highlights the value of cardiac magnetic resonance imaging in the early diagnosis of inflammatory CP and supports the role of medical therapy in selected patients.