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Pericardial Mesothelioma Masquerading as Rheumatic Heart Disease

Mynug Soo Shin, MD; Kang-Jey Ho, MD, PhD; Laurence B. Liu, MD, PhD
Arch Intern Med. 1977;137(2):257. doi:10.1001/archinte.1977.03630140097025.
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To the Editor.—  Pericardial mesothelioma occurs in 1 per 40 million population per annum1 and is manifested most commonly as constrictive pericarditis,2 but occasionally as hemorrhagic or cholesterol pericarditis,3 constriction of great vessels,4 and myocardial infarction.5 Reported here is an unique case masquerading acute rheumatic fever with mitral stenosis.

Report of a Case.—  A 24-year-old woman had suffered from several episodes of sore throat, easy fatigability, and low-grade fever since January 1974. On June 18, 1974, she was hospitalized for recurrent sore throat, low-grade fever, and retrosternal pain and was found to have tachycardia, loud pericardial friction rubs, an increased ESR (93 mm/hr), elevated antistreptolysin O titer (166 Todd units), and slight cardiomegaly on chest x-ray film. She was treated for acute rheumatic fever with cardiac involvement with aspirin and prednisone with much improvement and was discharged on July 6. She returned shortly with the same


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