Fig. 1

A Chest X-ray showed cardiomegaly and bilateral pleural effusion. No calcification of the pericardium was observed. B Bilateral pleural effusion and a small amount of pericardial effusion were detected in computed tomography. No calcification or thickening of the pericardium was observed. C Cardiac magnetic resonance imaging (cine image) demonstrated no thickening of the pericardium, nor adhesion between myocardium and pericardium. D Trans-thoracic echocardiographic color Doppler image of apical four-chamber view showed solitary severe TR and enlarged bilateral atria. E The pressure waveforms obtained for both the right and left ventricles on right heart catheterization demonstrated the “dip and plateau” pattern typical of constrictive pericarditis