case_images: PMC5831313_01
case_images: Abdominal ultrasound. Bladder wall thickening (red arrow).
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case_images: fig1
case_images: Ultrasound examination showed fluid in the abdominal cavity together with bladder wall thickening (Figure 1), hepatomegaly, and pleural and pericardial effusion.
case_images: Computed tomography (CT scan). Fluid accumulation within the pericardium and abdomen (red arrows).
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case_images: fig2
case_images: Computed tomography confirmed all these findings (Figure 2).
case_images: Transthoracic echocardiography. Parasternal short axis view (apex) showing a large pericardial effusion (>5 cm) with a swinging heart. Pulse wave Doppler (PWD) examination shows significant respiratory variations (i.e., >25%) in left ventricular diastolic filling pattern.
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case_images: fig3
case_images: Hg without evidence of pulsus paradoxus. However, echocardiography showed a large pericardial effusion (>5 cm) with significant respiratory variations (i.e., >25%) of mitral inflow and inferior vena cava plethora (Figure 3).
case_images: Transthoracic echocardiography. Constrictive pericarditis. Pericardial thickening with fibrin deposits (14 mm), ventricular interdependence ("septal bounce"), and abnormal tissue Doppler imaging ("annulus paradoxus" and "annulus reversus").
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case_images: fig4
case_images: A new echocardiogram after 6 weeks showed an evolution to constrictive pericarditis (Figures 4 and 5).
case_images: Transthoracic echocardiography. Constrictive pericarditis. Pericardial thickening with a large amount of fibrin totally encasing the heart.
case_images: CRII2018-2974756.005.jpg
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case_images: fig5
case_images: A new echocardiogram after 6 weeks showed an evolution to constrictive pericarditis (Figures 4 and 5).
case_images: Transthoracic echocardiography. Almost complete resolution of the pericardial disease after 5 weeks of therapy with glucocorticoids.
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case_images: fig6
case_images: Last follow-up echocardiogram (three weeks later) showed an almost complete resolution of the pericardial disease with mild residual thickening of both layers and residual deposits of fibrin (Figure 6).