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Cardiac manifestation of polyarteritis nodosa.

A 24-year-old woman patient presented with an 18-month history of fatigue, weight loss, transient exanthema, fever, and occasional palpita-tions. Dyspnoea, orthopnoea, and chest pain were denied. Clinical examination revealed tachycardia with a heart rate up to 122 b.p.m. Chest X-ray showed left-sided pleural effusion. Laboratory examination indicated increased acute-phase reactants (erythrocyte sedimenta-tion rate 102mm/h, c-reactive protein 65mg/dL), normal cardiac biomarkers, and negative rheumatologic antibodies (ANCA, ANA,