Figure 1.

Transthoracic echocardiography, computed tomography of the chest, and cardiac catheterization.

M-mode of the parasternal long-axis view shows a septal bounce or transient movement of the interventricular septum to the left ventricle during inspiration (A, arrow). A short-axis image without the administration of intravenous contrast material shows pericardial thickening overlying the whole heart on admission (B, arrows). Note that there was no pericardium thickness on the same level of the heart on computed tomography performed 4 months earlier for the assessment of pulmonary fibrosis (C). The systolic, diastolic, and end-diastolic pressures are 32/8/15 mm Hg in the right ventricle (RV) and 140/8/16 mm Hg in the left ventricle (LV), both of which exhibit similar pressure curves during diastole, known as a “dip-and-plateau” pattern (D). The right atrial (RA) pressure is 15/10 mm Hg (mean 13 mm Hg), which is a “W” or “M” configuration (E).