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A 21-year-old female patient was admitted to the emergency department with a 1-month history of dyspnoea increasing over the last few days. Transthoracic echocardiogram demonstrated a massive pericardial effusion reaching 2.1 cm at its widest with right ventricular outflow tract diastolic collapse (online supplementary file 1). Urgent fluoroscopy-guided pericardiocentesis via the subxiphoid approach was performed. A total of 1000 cc of milky fluid was removed (online supplementary file 2). The laboratory results of the fluid revealed a triglyceride level of 592 mg/dL and an Lactate Dehydrogenase (LDH) level of 392 U/L. On physical examination, a swollen puffy face, jugular venous distention, and venous collaterals along the chest and abdomen were observed (online …
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