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Shelled heart: tuberculous constrictive pericarditis
  1. G Rajesh,
  2. Deepak Raju,
  3. M N Krishnan
  1. 1Department of Cardiology, Government Medical College, Kozhikode, Kerala, India
  1. Correspondence to Dr Deepak Raju, Department of Cardiology, Government Medical College, Kozhikode, Kerala 673008, India; drj980{at}

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A 55-year-old man presented with progressive distension of the abdomen, pedal oedema, effort dyspnoea and excessive fatigue. Physical examination showed facial puffiness, distended neck veins with prominent Y descent in jugular venous pressure, ascites, systolic retraction of the chest wall and a loud pericardial knock. Echocardiography showed greatly thickened pericardium (figure 1A) …

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