Figure 3. Histology of the resected nodular specimen showing a papillary lesion characterised by central fibroelastic stroma covered by endothelial cells, characteristic of papillary fibroelastoma.of papillary fibroelastoma (Fig. 3). Repeat TTE 12 months post-resection showed no evidence of tumour recurrence and a reduction in estimated pulmonary arterial pressure to 49 mmHg.Papillary fibroelastomas are rare, benign cardiac tumours with an incidence of 0.00017-0.033% [1]. They usually arise from cardiac valvular endocardium but can develop anywhere in the heart. The predominant location is on the aortic valve with the pulmonary valve the least commonly affected valve [2]. Some patients present with symptoms of embolisation or obstruction whilst others are asymptomatic. This case illustrates the importance of adequate imaging of the pulmonary valve which in practise is often technically difficult. W e present a case of a 43-year-old woman with a history of chronic idiopathic pericardial effusion, which has been diagnosed 6 years ago. The patient reported an increasing dyspnea over the last 2 months. Echocardiographic examination showed a massive pericardial effusion with compromise of the right atrium and ventricle, and an increase in the respiratory variation of mitral valve inflow velocities, suggested of haemodynamic
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