An 83-year-old patient underwent surgery for empyema of metatarsophalangeal joint five days ago. The postoperative period was without any signs of complication, no sepsis developed. She was admitted to ICU for worsening dyspnea. Hypervolemia with retention of fluid was diagnosed. Significant fluidothorax developed bilaterally. The patient had had no history of cardiac problems so far. She complained of worsening dyspnea during physical activity over the past few months. No stenocardia was present. Her history encompasses rheumatoid arthritis (prednisone 4 mg per day) and arterial hypertension.

 

Echocardiography was performed:

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