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A rare cause of heart failure with preserved ejection fraction: primary pericardial mesothelioma masquerading as pericardial constriction
  1. Russell Fernandes1,
  2. Shravan Nosib2,
  3. Dorothy Thomson3,
  4. Nick Baniak4
  1. 1Department of Internal Medicine, University of Saskatchewan, Saskatoon, Canada
  2. 2Department of Cardiology, University of Saskatchewan, Saskatoon, Canada
  3. 3Department of Cardiovascular Surgery, University of Saskatchewan, Saskatoon, Canada
  4. 4Department of Pathology University of Saskatchewan, Saskatoon, Canada
  1. Correspondence to Dr Russell Fernandes, russellwf{at}


We present a case of a 30-year-old woman with a history of HIV and hepatitis C who sought medical attention because of severe oedema of the lower limbs and abdomen. CT of the chest showed a thickened pericardium, and cardiac catheterisation demonstrated constrictive physiology. She underwent pericardiectomy, but the procedure was unsuccessful because the pericardium was densely adherent to the myocardium. After consultation with several pathologists, she was diagnosed with primary pericardial mesothelioma (PPM), an exceedingly rare cardiac tumour with a fatal prognosis. She died within 3 months of presentation. The details of the case as well as pertinent literature are reviewed.

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