<s>[INST] My 74 year old rhematoid arthritic father presents 7 out of 10 pain in his occipital region and dizziness in sit to stand transfers. Chest CT results indicate enlarged heart, sac of fluid in right lung. Had a 102 fever 2 days ago but is now normal. Was under antibiotics, currently taking Lyrica for pain in head, prednisone increased to daily 60 mg. I realize he has a lot going on but am interested in any direction. Thank you. [/INST] Hi, Welcome, this is Chat Doctor. Enlarged heart can be because of lots of causes. Rheumatoid arthritis can be one of them. I'll recommend you to first get a 2D Echo done to know the exact abnormality of heart which will guide the treatment ahead. He will need extra medicines for the enlarged heart. Sac of fluid around the lung (pleural effusion) could be because of infection. If it is large enough, it may need removal by needle. If is not very large, then we just give medicine to control the infection, and with control of infection, this fluid sac will gradually resolve. Wishing him a quick recovery. ThanksTake care </s>