Establishing the tuberculous (TB) ethology of pericarditis is crucial, as the prognosis is excellent when appropriate specific treatment is administered. However, the clinical presentation may be non-specific, and the diagnosis can be overlooked even in patients having cardiac tamponade. With   the global spread of HIV infection the incidence of tuberculous pericarditis has risen significantly. While tuberculosis accounts for less than 4% of pericarditis cases in developed countries, increasing reports from other regions have emerged due to global migration and the spread of HIV. Tuberculous pericarditis (TBP) is prevalent in African and Asian countries and is responsible for 50–70% of pericardial disease cases in sub-Saharan Africa. Echocardiography remains the most critical diagnostic modality for tuberculous   pericarditis and cardiac tamponade as well, providing essential information for early recognition and management. A definitive diagnosis of tuberculous pericarditis requires the isolation of Mycobacterium tuberculosis from pericardial fluid; however, isolating the organism is often challenging. Diagnosis may also depend on histopathological examination of pericardial tissue or culture of M. tuberculosis from pericardial tissue or fluid. Tuberculosis is associated with an increased risk during the peripartum period, including pregnancy and postpartum. So, early recognition and prompt initiation of therapy are crucial for improving patient outcomes and preventing complications, including cardiac tamponade and constrictive pericarditis. We report a case of a 21-year-old woman in the postpartum period with massive pericardial effusion complicated by cardiac tamponade, successfully managed with urgent pericardial drainage and six months of anti-tuberculosis therapy.
Keywords: Tuberculous Pericarditis, Cardiac Tamponade, Postpartum period,  Pericardial effusion