A 56-year-old female presented to the ED with complaints of progressive shortness of breath and fatigue. The patient had a 6-year history of stage II breast cancer (left breast). Physical examination Hypotension Tachycardia Jugular venous distention Pulsus paradoxus Distant heart sounds Blood pressure: 63/44 mm hg Heart rate: 110 beats/min Echocardiography analysis Transthoracic echocardiography of the patient revealed: A large pericardial effusion with the impression of the heart swinging freely in an anterior-posterior fashion. The right and left atria in end-diastole were collapsed, which were consistent with the cardiac tamponade.
The left ventricular systolic function was also found to be moderately impaired. There was a beat-to-beat variation in both the amplitude and the axis of the QRS complex ( Fig. 1 ). Radiograph analysis The chest radiograph analysis of the patient revealed:…
