Abstract
This report describes the presence of massive pericardial effusion in a 68-year-old man who was markedly disabled and presented manifestations of “restrictive” ventricular failure. Initial pericardiocentesis yielded greenish-gold pericardial fluid which contained excessive amounts of free cholesterol and many “cholesterol” crystals. Removal of the pericardial fluid by two separate aspirations resulted in the disappearance of all the symptoms and signs. No definitive etiological factor was found, and the case was considered to be one of idiopathic cholesterol pericarditis with effusion. In the literature, only 5 cases of similar nature were reported. The salient clinical features of these 5 cases were reviewed and summarized. Complete recovery resulted from multiple pericardiocenteses alone in 3 cases, whereas subsequent pericardiectomy was required in the other 2 cases.
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