The presence of cardiomegaly may be seen in the minority of cases where a significant pericardial effusion has accumulated. The following diagnostic algorithm has been proposed. All patients should have a complete history and physical examination, electrocardiography, and chest radiography. Diagnosis specific testing should include tuberculin skin testing, rheumatoid factor and antinuclear antibody, viral studies from pharyngeal, and fecal swabs. I hope you find this information useful.
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