Cine 4CH: Severe thickening of the pericardium, that forms a non-compliant shell around the heart. Normal sized LV and RV with normal systolic function, but septal bouncing due to ventricular interdependence.
LGE 4CH with severely thickened and enhanced pericardium.
LGE SA with severely thickened and enhanced pericardium.
Real Time SA acquisition showing ventricular interdependence: The heart is unable to adapt to the increase in volume of the right heart during diastole, especially during inspiration. To accommodate the volume, the septum shifts to the left during inspiration and decreases LV stroke volume (also called pulsus paradoxus).
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