title: An unusual presentation of cardiac tamponade associated with Epstein-Barr virus infection.
abstract: We present a case of an 80-year-old woman who presented with a dry cough, shortness of breath and general malaise. She had presented 5 days previously with a sore throat, feeling feverish and with non-specific symptoms. Her background included paroxysmal atrial fibrillation and hypertension. She was initially thought to have decompensated heart failure secondary to atrial fibrillation and was initiated on diuretic therapy. However, a transthoracic echocardiogram performed revealed collapse of the right ventricle and a swinging heart, suggestive of cardiac tamponade. The patient underwent therapeutic pericardiocentesis where 700 mL of exudative, blood-stained fluid was drained. Subsequent testing of the pericardial fluid revealed the presence of Epstein-Barr virus DNA. Serial follow-up transthoracic echocardiograms revealed resolution of the pericardial effusion and the patient remained asymptomatic.
authors.affiliation: Department of Care of Older People, The Whittington Hospital, London, UK.
authors.forename: Kai Man Alexander
authors.initials: KM
authors.lastname: Ho
authors.affiliation: Department of Care of Older People, The Whittington Hospital, London, UK.
authors.forename: Sheena C
authors.initials: SC
authors.lastname: Mitchell
mesh_terms: D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging* / Q000628:therapy* / Q000821:virology; D004417:Dyspnea / Q000209:etiology; D004452:Echocardiography; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000175:diagnosis*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D020519:Pericardiocentesis; D016896:Treatment Outcome