Abstract
finding related to pericardium (Figure 3). It was the severe TR itself and secondary right heart enlargement causing restraining effect on the intact pericardium. Operation for tricuspid valve was decided. The pericardium was normal and tricuspid annulus was severely dilated on surgical inspection. Tricuspid valve was replaced with a bioprosthetic valve. The patient did well just after the surgery with a rapid decrease in cardiac pressures. However she died due to respiratory failure on the postoperative 15th day. This was a case with right heart failure symptoms in which invasive hemodynamic findings were consistent with constrictive pericarditis and the noninvasive imaging modalities were not. This case illustrates that severe TR can mimic some hemodynamic findings of constrictive pericarditis due to restraining effect of the enlarged right heart on intact pericardium and on left ventricle [1]. Lack of significant respiratory changes in hemodynamic parameters which can safely be demonstrated in echocardiography and cardiac MRI, must suggest a normal pericardium.
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