CP may involve only portions of the pericardium. In such cases, the condition is named 'localized CP'. Imaging methodologies play an important role in the diagnosis of this condition. A 55-year-old man with a history of tuberculosis presented with signs of heart failure. Chest X-ray showed pericardial calcifications confirmed on computed tomography (Fig. 1). Echocardiography showed pericardial hyperecogenicity at the mid portion of both left and right ventricular walls and left atrium enlargement (Fig. 2). Contractile dilatation of the apex was present. In M-mode tracing of the mitral valve, there was a steep E-F slope, as for rapid early diastolic filling. Pulsed-wave Doppler showed respiratory variation in transmitral flow: increased early diastolic filling during expiration compared with inspiration. CMR imaging in the four-chamber plane showed a focally thickened pericardium at the level of the middle right and left ventricles, causing localized ventricular constriction (Fig. 3A). In particular, CMR showed an apical right and left ventricular contractile pseudo-ballooning deformation due to the higher intraventricular filling pressure in areas without pericardial constriction (Fig. 3B and C; Supplementary data, Video 1). As usually seen in constriction, real-time cine magnetic resonance on the interventricular septum with deep breath showed abnormal interventricular coupling.