Cardiac tuberculosis refers to the rare infection of the heart with Mycobacterium tuberculosis.
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Pathology
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 haematogenous route.
Radiographic features
Plain radiograph
acute stage: no findings in heart, but active lung infection may be present
chronic stage: pericardial calcification
CT
pericardial effusion (mild)
pericardial thickening
pericardial calcification (chronic stage)
MRI
T1: nodular lesion which appears isointense to slightly hyperintense
T2: isointense
C+ Gd: mild heterogeneous enhancement
Treatment and prognosis
Patients generally respond well to antituberculous therapy. Clinical examination, known primary pulmonary infection and follow-up examinations will help confirm the diagnosis.
Differential diagnosis
Imaging differential considerations include:
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