Revision 12 for 'Cardiac tuberculosis'

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Cardiac tuberculosis

Cardiac tuberculosis refers to the infection of the cardiac musculature with Mycobacteria tuberculosis. It is a rare entity but known to occur.

Pathology

Generally associated with and occuring as a complication of mediastinal and pulmonary tuberculosis.

Pericardial and myocardial involvement is known. Endocardial spread may occur from myocardium. Modes of spread to the myocardium are via  lymphatics from mediastinal nodes, directly from the pericardium, or via a hematogenous route. 

Radiographic features

Plain film
CT
CMR (cardiac magnetic resonance imaging)
  • T1 - nodular lesion which appear isointense to slightly hyperintense
  • T2 - isointense 
  • C+ Gd+ - mild heterogenous enhancement

Differential diagnosis

Imaging differential considerations include

Treatment and prognosis

Patients generally respond well to anti-tubercular therapy. Clinical examination, known primary pulmonary infection and follow-up examinations will help confirm the diagnosis.

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