Where is the primary abnormality?
Diffuse pericardial thickening is seen, causing a multiude of related abnormalities.
What could have been the most likely etiology in this patient?
Pericardial thickening could be caused to post-operative radiotherapy.
What are the signs of cardiac failure seen in this patient?
Dilated right atrium, superior and inferior venacava, may suggest congestive heart disease.
What is the final diagnosis?
Case most likely represents constrictive pericarditis. A supportive finding is indentation of right ventricle by thickened pericardium.
There is diffuse thickening of the anterior pericardium, upto the vascular root, best seen in multiplanar reformat images. Indentation of right ventricle is seen, causing a "tubular" configuration.
Post-operative changes are seen in left chest wall.
The inferior vena cava is dilated to more than double the aortic diameter.