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A 23-year-old girl had been bloating with no obvious incentive for 2 months. Physical examination revealed the presence of abdominal distension, positive shifting dullness and umbilical hernia ( Panel A ). Computed tomographic scanning of the abdomen showed massive ascites and serious hepatic congestion ( Panel B ), therefore, a continued echocardiography was conducted. The echocardiography remarkably displayed the dilation of the right atrium with signs …

Severely dilated right atrium with spontaneous coronary sinus thrombus