Een benauwde man met afwijkende QRS-complexen

A 69-year-old patient came to the Emergency Department with dyspnea on exertion. ECG showed QRS alternans and echocardiography showed pericardial effusion. The diagnosis ‘pericarditis carcinomatosis’ was made after pericardial fenestration. QRS alternans is caused by the swinging motion of the heart, due to the excess of pericardial fluid.

Conflict of interest: none declared. Financial support: none declared.