Final diagnosis- Pericardial Effusion.

Question 1. What are the causes of Exertional dyspnoea -

• Cardiac causes are the most common, particularly heart failure, which is typically graded into four classes based on severity.

• Respiratory causes - bronchial asthma

• Haematological causes - severe anaemia, significant polycythaemia.

Question 2. X-ray Chest- Huge Cardiomegaly. Causes -

• Chronic Congestive Heart Failure

• Pericardial Effusion

• Epstein's Anomaly

• Cardiomyopathies.

Question 3. ECG Findings-

• Low voltage complexes and Electrical Alternance

The patient was transferred to a regional tertiary centre, where she underwent a pericardiocentesis—a procedure involving the drainage of fluid from the pericardial space. This procedure can be both diagnostic and therapeutic.

In this case, approximately 1.5 litres of fluid was drained. Unfortunately, the final underlying cause of the pericardial effusion was not known.