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Shortly after admission, she developed AF with rapid ventricular response, responsive to intravenous amiodarone. Transthoracic echocardiogram revealed 2.4\u2009cm posterior PE without tamponade physiology, non-amenable to pericardiocentesis via sub-xiphoid approach. Patient underwent left thoracoscopic pericardial window with removal of 250 cc bloody fibrinous fluid. Cough improved significantly and she was discharged on oral amiodarone and apixaban. Repeat CT chest after 2\u2009weeks for recurrent cough showed a small PE, treated with oral prednisone for suspected postablation pericarditis, with complete resolution of cough. Amiodarone was stopped without recurrence of AF.<\/jats:p>","DOI":"10.1136\/bcr-2017-222327","type":"journal-article","created":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T02:25:20Z","timestamp":1517883920000},"page":"bcr-2017-222327","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cough as the sole manifestation of pericardial effusion"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-2533","authenticated-orcid":false,"given":"Hee Kong","family":"Fong","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Missouri Health Care, Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Obai","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Gautam","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,5]]},"reference":[{"doi-asserted-by":"publisher","key":"2025082723344378000_2018.feb05_1.bcr-2017-222327.1","DOI":"10.1097\/01.CCM.0000271159.84639.2B"},{"unstructured":"Singhal PT P , Butany J . 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