Cardiac tuberculosis refers to the infection of the cardiac musculature with Mycobacterium tuberculosis. It is a rare entity but known to occur.
Generally associated with and occurring 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.
- acute stage: no findings in heart; active lung infection may be present
- chronic stage: pericardial calcification
- pericardial effusion (mild)
- pericardial thickening
- pericardial calcification (chronic stage)
- T1: nodular lesion which appear isointense to slightly hyperintense
- T2: isointense
- C+ Gd: mild heterogeneous enhancement
Treatment and prognosis
Patients generally respond well to antitubercular therapy. Clinical examination, known primary pulmonary infection and follow-up examinations will help confirm the diagnosis.
Imaging differential considerations include