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A 56-year-old woman presented with acute dyspnoea and oedema of the legs. As pre-existing condition, she had a stable rheumatoid arthritis under treatment with methotrexate and adalimumab.
Contrast-enhanced computed tomography of the chest did not demonstrate an acute pulmonary embolism or pulmonary oedema. Peripheral venous thrombosis was excluded by sonography.
Real-time three-dimensional (3D) echocardiography showed an extensive left and right ventricular thrombotic …
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