A 35-year-old male presented with a 2-year history of repeated presentation of heart failure, evidenced by progressive dyspnoea (New York Heart Association [NYHA] III), abdominal enlargement, jaundice, and bilateral leg oedema. These complaints had also happened 15 years before (at the age of 20), when the patient was diagnosed with pulmonary tuberculosis (TB) with pericardial complications and underwent pericardial tapping. The patient then completed a 12-month anti-TB regimen and was declared free from TB; he was then lost to follow-up. The current presenting physical examination found blood pressure of 105/75 mmHg and heart rate of 86 beats/minute. There were icteric sclerae, elevated jugular venous pressure, positive Kussmaul's sign, bilateral pulmonary rhales, ascites, hepatomegaly, and pretibial pitting oedema. Chest X-ray revealed pericardial calcification on the anterior and inferior apex of …