A 24 year old man, recently known to have hypertension was admitted to our hospital for acute shortness of breath with central chest pain. His investigations revealed end stage renal disease with a normochromic normocytic anaemia. There was cardiomegaly on his chest radiograph and initial echocardiography did not reveal a pericardial effusion. Haemodialysis was initiated and his renal profile steadily improved. His serial chest radiographs from day 10 post hemodialysis showed increasing heart size. Echocardiography revealed a new pericardial effusion without the signs of pericardial tamponade.His pericardial effusion was completely resolved 4 weeks after admission with more intensive haemodialysis regimens, including daily short dialysis. This supports the notion that patients with uremic pericarditis resolve rapidly with intensive dialysis.
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