Presentation of the patient
September 2019	Main complaint: exertional dyspnoea (New York Heart Association III).
	CXR: cardiomegaly, pulmonary congestion.
	Transthoracic echocardiogram (TTE): dilation of both atria, moderately reduced LVEF (35%), mildly reduced systolic RV function. Severe mitral valve regurgitation (MR), moderate TR, aortic and pulmonary valves with no relevant pathologies. No pericardial effusion.
	Cardiac catheterization: no stenosing coronary artery disease. Post capillary pulmonary hypertension.
Intervention
September 2019	Transcatheter mitral valve repair, implantation of one Clip.
Post-procedural course
Day 0	TTE: No evidence of pericardial effusion immediately after the procedure.
Day 1	TTE: No evidence of pericardial effusion.
Day 3	Patient complained of malaise, fatigue and epigastric pain.
	C-reactive protein (CRP) 80 mg/L (normal <5 mg/L), procalcitonin (PCT) 0.16 ng/mL (normal <0.5 ng/L).
	TTE: Mild circular pericardial effusion (8 mm).
Day 5	CRP 200 mg/L, PCT 0.17 ng/mL.
	TTE: Stable pericardial effusion.
Day 7	CRP 290 mg/L, PCT 0.15 ng/mL.
	TTE: progress of the pericardial effusion (13 mm).
	CT: serous pericardial effusion, bilateral pleural effusion.
Management	Initiation of anti-inflammatory therapy with Aspirin and Colchicine
Day 10	CRP 230 mg/L.
	TTE: regression of the pericardial effusion (10 mm).
Day 12	CRP 137 mg/L.
	Cardiac magnetic resonance: thickening of the pericardium with late gadolinium enhancement and mild pericardial effusion.
Day 15	CRP 40 mg/L.
	TTE: no evidence of pericardial effusion.
Discharge of the patient
Follow-up
Day 30	CRP 1.4 mg/L.
	TTE: no evidence of pericardial effusion, mild residual MR.
	CXR: no pleural effusion