Flu A worsening SOB

A 94yo was seen in ED with acute increased SOB on a background of recent Flu A diagnosis. 

Subxyphoid

There were B lines both anterior lung fields with normal thin pleura

R1 and L1 (similar to R1)

This patient's SOB was probably due to combination of APO, inadequate output from decreased LV filling secondary to the effusion and Flu A. Given the patient's age and comorbidities, stable obs and absence of features of tamponade, this patient was managed conservatively.