Echo-Bright Pericardium in Recurrent Idiopathic Pericarditis

Various radiological findings are observed in acute pericarditis, including pericardial thickening, pericardial effusion, and elevated filling pressures on transthoracic echocardiogram (TTE); thickened pericardium on cardiac CT; edematous pericardium depicted in T2 black-blood/short tau inversion recovery (STIR) images; and enhancement with late gadolinium enhancement (LGE) on cardiac MRI. However, the presence of a bright pericardium on TTE has seldom been reported. We report a case of acute pericarditis, diagnosed in a young female patient based only on typical chest pain and elevated inflammatory markers. Initially negligible, a bright pericardium was prominent on the recurrent episode after one year of the initial presentation.