Unusual cause of right heart compression.

We report the case of a 77 year-old Caucasian woman with a past medical history of breast cancer who presented to our institution with a five-week history of progressive shortness of breath associated with abdominal distension, anorexia, change in bowel habit and cough. She had an ejection systolic murmur and a pansystolic murmur radiating to the axilla, a raised jugular venous pressure, abdominal distension with shifting dullness and hepatomegaly 16 cm below the costal margin. Blood results revealed a normocytic anemia with deranged liver function tests, renal impairment and a raised C-reactive protein. Chest radiograph demonstrated a raised right hemidiaphragm (Fig. 1A). Transtho-