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A not so typical pericardial effusion case…
  1. William R Miranda,
  2. Darrell B Newman,
  3. Rick A Nishimura
  1. Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Rick A Nishimura, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; rnishimura{at}mayo.edu

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Clinical introduction

A 71-year-old woman with paroxysmal atrial fibrillation and hypothyroidism on hormone replacement presented with a 3-month history of progressive exertional dyspnoea and decline in functional capacity. She was evaluated and found to have a moderate circumferential pericardial effusion on transthoracic echocardiography without 2D or Doppler signs of tamponade physiology. Laboratory test showed normal thyroid-stimulating hormone and C-reactive protein levels, and sedimentation rate. Tuberculosis testing was negative and rheumatological panel was unrevealing. She was started on colchicine for idiopathic pericarditis. Due to progressive symptoms, she was referred …

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