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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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