Cardiac Magnetic Resonance Finding in Constrictive Pericarditis

A patient presented with constrictive pericarditis. For pericardial characterization, cardiac magnetic resonance imaging (CMR) was performed. The real-time cine imaging sequence in the short-axis plane during free breathing is shown in the video, which demonstrates the displacement of the interventricular septum towards the left ventricle during inspiration, which is called respirophasic septal shift. This is seen in constriction because of ventricular interdependence. During inspiration, because of less left ventricular filling, the interventricular septum moves to the left. During expiration, with better left ventricular filling, the septum moves back to its normal position. This is different from the septal bounce or shudder, which occurs in every cardiac cycle independent of breathing due to differential filling rates of the left and right ventricle in the diastole. Click the Related Article link for a review of CMR findings of constrictive pericarditis and the Related Video links to watch multimodality imaging findings of constriction.