A rare case of cardiac tamponade due to tuberculosis


  • Deependra K. Rai Department of Pulmonary Medicine, AIIMS, Patna, India
  • Abhishek Kumar Department of Pulmonary Medicine, AIIMS, Patna, India




Tuberculosis, Pericardial effusion, Pericarditis


Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity. Tuberculosis involvement of the pericardium is well-known and can result in pericardial tamponade apart from other sequelae like constrictive pericarditis. Here we report a case of 60 years old female of pleuropericardial effusion presented with acute onset breathlessness, palpitation, tachypnea. Urgent echocardiography shows cardiac tamponade. Pericardiocentesis was performed immediately and more than one litre hemorrhagic fluid drained. Patient was put on anti-tubercular treatment with oral steroid after adenosine deaminase positivity in exudative pericardial fluid. Patient is doing well in follw-up visit.


Fowler N. Tuberculous Pericarditis. JAMA. 1991;266(1):99.

Zayas R, Anguita M, Torres F, Gimenez D, Bergillos F, Ruiz M et al. Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis. Am J Cardiol. 1995;75(5):378-82.

Navarrete OC, Ortuno MF, Rocamora PJ, Fernández GA, Paya CV, Martínez MJ et al. Debemos pensar en una etiología específica en pacientes con taponamiento cardíaco? Revista Espanola de Cardiologia. 2002;55(5):493-8.

Strang J, Gibson D, Mitchison D, Girling D, Kakaza H, Allen B et al. Controlled clinical trial of complete open surgical drainage and of prednisolone in treatment of tuberculous pericardial effusion in transkei. Lancet. 1988;332(8614):759-64.

Cherian G. Large pericardial effusion: the differentiation of tuberculous from chronic idiopathic effusion. J Assoc Physicians India. 2003;51:880-3.

Massasso D, Lee K, Sharma P. Joined at the hip: rheumatoid arthritis and tuberculosis. Med J Aust. 2008;188:164-5.

Reuter H, Burgess L, Doubell A. Epidemiology of pericardial effusions at a large academic hospital in South Africa. Epidemiol Infect. 1999;133(3):393-9.

Harrison T, Longo D. Harrison's manual of medicine. New York: McGraw-Hill Medical; 2013.

Sauleda SJ, Miralda PG, Soler SJ. Tuberculous pericarditis: ten year experience with a prospective protocol for diagnosis and treatment. J Am College Cardiol. 1988;11(4):724-8.

Haas DW, Prez RM. Tuberculous pericarditis. Mandell, Douglas and Bennett's principles and practice of infectious disease. Mandell GL, Bennett JE, Dolin R (eds). 4th Edition. 1995:2236.

Cohen R, Muzaffar S, Schwartz D, Bashir S, Luke S, Mcgartland L et al. Diagnosis of pulmonary tuberculosis using pcr assays on sputum collected within 24 hours of hospital admission. Am J Respir Crit Care Med. 1998;157(1):156-61.

Atar S. Bloody pericardial effusion in patients with cardiac tamponade. Chest. 1999;116(6):1564.