{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T10:56:20Z","timestamp":1758452180401,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"13","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2017,2,2]]},"published-print":{"date-parts":[[2017,7]]},"abstract":"\n Clinical introduction<\/jats:title>\n A 51-year-old woman was referred to our hospital with a 4-month history of progressive dyspnoea on exertion (New York Heart Association Functional Classification III), chest heaviness, dry cough, weight loss and tiredness. She worked as cleaning woman and had no relevant medical history, apart from an Epstein-Barr Virus (EBV) infection 2 months before symptom onset. She did not smoke and family history was negative.<\/jats:p>\n On examination, blood pressure was 104\/80\u2009mm\u00a0Hg and heart rate was regular at 145 bpm. On auscultation, heart sounds were distant, muffled and there was no murmur. Minimal, bilateral pitting oedema was observed. Laboratory findings were unremarkable. During hospitalisation, cardiac monitoring revealed paroxysmal new-onset atrial fibrillation.<\/jats:p>\n Chest radiography from a previous hospital had revealed cardiomegaly and subsequent echocardiography had shown pericardial effusion with diastolic dysfunction, for which she had received percutaneous pericardiocentesis. However, repeated echocardiography at our hospital showed recurrence of pericardial effusion with diastolic dysfunction and the presence of a pericardial mass. CT and Fluorine-18-fluorodeoxyglucose PET\u00a0(18<\/jats:sup>F-FDG\u00a0PET) scanning\u00a0were done (figure 1).<\/jats:p>\n \n Figure 1<\/jats:label>\n \n | Contrast-enhanced CT scanning and 18<\/jats:sup>F-FDG\u00a0PET scanning. (A)\u00a0CT scan, sagittal view; (B) 18<\/jats:sup>F-FDG\u00a0PET scan, frontal view; \u00a0(C) CT scan, axial view and\u00a0(D) 18<\/jats:sup>F-FDG\u00a0PET scan, axial view.<\/jats:p>\n <\/jats:caption>\n \n <\/jats:fig>\n <\/jats:sec>\n \n Question<\/jats:title>\n Which of the following is the most likely diagnosis?<\/jats:p>\n And based on patient history and imaging, are further diagnostics needed?\n \n Benign pericardial lipoma<\/jats:p>\n <\/jats:list-item>\n \n Fibrinofibrous pericarditis following EBV infection<\/jats:p>\n <\/jats:list-item>\n \n Inflammatory pseudotumor<\/jats:p>\n <\/jats:list-item>\n \n Primary cardiac lymphoma<\/jats:p>\n <\/jats:list-item>\n \n Primary malignant pericardial mesothelioma<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/heartjnl-2016-311101","type":"journal-article","created":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T20:50:22Z","timestamp":1492807822000},"page":"1053-1053","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A middle-aged woman with a heavy heart"],"prefix":"10.1136","volume":"103","author":[{"given":"Cedric","family":"Van de Bruaene","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Crap\u00e9","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veerle","family":"Surmont","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,4,21]]},"reference":[{"key":"2025092021442668000_103.13.1053.1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.336135512"},{"key":"2025092021442668000_103.13.1053.2","doi-asserted-by":"crossref","first-page":"9256","DOI":"10.1186\/1752-1947-0003-0000009256","article-title":"Primary malignant pericardial mesothelioma - a rare cause of pericardial effusion and consecutive constrictive pericarditis: a case report","volume":"3","author":"Butz","year":"2009","journal-title":"J Med Case Rep"},{"key":"2025092021442668000_103.13.1053.3","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1007\/s00595-013-0511-y","article-title":"Three-year survival after surgery for primary malignant pericardial mesothelioma: report of a case","volume":"44","author":"Fujita","year":"2014","journal-title":"Surg Today"},{"key":"2025092021442668000_103.13.1053.4","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012-0214-OA"},{"key":"2025092021442668000_103.13.1053.5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1136\/heart.90.1.e4","article-title":"Primary pericardial mesothelioma presenting as pericardial constriction: a case report","volume":"90","author":"Suman","year":"2004","journal-title":"Heart"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heartjnl-2016-311101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T04:44:33Z","timestamp":1758429873000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heartjnl-2016-311101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,21]]},"references-count":5,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2017,6,14]]},"published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1136\/heartjnl-2016-311101"],"URL":"https:\/\/doi.org\/10.1136\/heartjnl-2016-311101","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"type":"print","value":"1355-6037"},{"type":"electronic","value":"1468-201X"}],"subject":[],"published":{"date-parts":[[2017,4,21]]}}}