A 52-year-old man is brought to the emergency department because of worsening shortness of breath for 6 hours. For the past 5 days, he has had intermittent stabbing pain in the middle of his chest that worsens with lying down or taking deep breaths. He has a history of stage 4 chronic kidney disease due to chronic glomerulonephritis. Systolic blood pressure decreases by 12 mm Hg during inspiration. Physical examination shows distant heart sounds and clear lungs. Echocardiography in this patient is most likely to reveal which of the following findings?

Question

A 52-year-old man is brought to the emergency department because of worsening shortness of breath for 6 hours. For the past 5 days, he has had intermittent stabbing pain in the middle of his chest that worsens with lying down or taking deep breaths. He has a history of stage 4 chronic kidney disease due to chronic glomerulonephritis.  Systolic blood pressure decreases by 12 mm Hg during inspiration.  Physical examination shows distant heart sounds and clear lungs.  Echocardiography in this patient is most likely to reveal which of the following findings?

Quizplus · Accepted Answer

Eductional Objective: Cardiac tamponade involves restriction of diastolic filling of the right-sided heart chambers, with engorgement and decreased inspiratory collapse of the inferior vena cava seen on echocardiography.  Pulsus paradoxus (>10 mm Hg drop in systolic blood pressure during inspiration) is commonly present with tamponade.

A 52-Year-Old Man Is Brought to the Emergency Department Because