PMC9699737_01
Upright PA chest X-ray showing faint opacity in the lower zone of the left lung.
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The patient's chest X-ray (Figure 1) showed faint left lower lung zone opacity.
(a) The axial image and (b) the coronal image of the CT scan of the chest post administration of IV contrast showing diffuse pericardial thickening and pericardial fat stranding (black arrow) with small left pleural effusion (white arrow).
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CT scan (Figure 2) shows pericardial thickening with surrounding fat stranding and small pericardial and left pleural effusions.
Transthoracic echocardiogram in the long parasternal axis view (a) and short axis view (b).
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After that, an echocardiogram was done (Figures 3 and 4) which showed a small pericardial effusion and pericardial thickening around the apex of the left and right ventricles.
Apical 4 chamber views show pericardial thickening around the apex of left and right ventricles. White arrows; in addition to small pericardial effusion.
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fig4
After that, an echocardiogram was done (Figures 3 and 4) which showed a small pericardial effusion and pericardial thickening around the apex of the left and right ventricles.
The patient's electrocardiogram showed sinus rhythm, with PR segment elevation in lead aVR (12 lead).
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An electrocardiogram (Figure 5) showed sinus rhythm and PR segment elevation in lead aVR.
Enhanced CT scan of the chest after a complete course of colchicine and ibuprofen showing improvement of the pericarditis evident by significant improvement of the pericardial thickening and resolution of the pericardial and left pleural effusions.
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An enhanced CT scan of the chest (Figure 6) showed marked interval improvement of the pericardial thickening with interval resolution of the pericardial and left pleural effusions.
(a) Selected image of transthoracic echocardiogram in apical 4 chamber view and (b) a parasternal long axis view showing marked interval improvement of the pericardial thickening with resolution of the pericardial effusion.
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Also, an echocardiogram was done (Figure 7) showing interval improvement of the pericardial thickening with interval resolution of the pericardial effusion, and the C-reactive protein turned to the normal limit.