Pericardial effusion causing ventricular arrhythmias: atypical presentation

[2] An acute collection of rapidly increasing pericardial effusion leads to pericardial tamponade which presents with hypotension, raised central venous pressure, and muffled heart sounds (Beck's triad), along with dyspnoea, chest pain, tachycardia and oliguria. A 51 year old woman with severe mitral stenosis, moderate tricuspid regurgitation and good left ventricular (LV) systolic function underwent mitral valve replacement with a 31-mm bio-prosthetic valve (St. Jude Medical Inc. Minnesota, USA) and tricuspid valve de-Vega annuloplasty.