Features of heart failure

Exudative pericardial effusion

Notch or retraction of right sided cardiac chambers (never in left sided chambers)

Skin lesions


Prominent fibrous strands and may appear as “cobra head” in cardiac chambers and pericardial space

Skeletal muscle atrophy

Pleural effusion rarely

Aneurysmal right atrium

Giant exudative ascites

Endocardial calcification

Biatrial enlargement

Biventricular enlargement

Aneurysmal right ventricle

Aneurysmal left ventricle

Dilated cardiomyopathy

Apical and endocardial

Fibrosis with apical obliteration and tethering of AV valve leaflets to the ventricular walls