Increasing SOB

Patient was seen with one month of fatigue, SOB and dry cough. 

HR 120 BP 136/100, RR 20 sats 100

subxyphoid

A4C

IVC

So this patient has a large pericardial effusion. In itself, this is one of the best predictors of tamponade. But he also has all the other echo features of tamponade. With a normal BP, clinically he is stable. But these patients go on to collapse with any decrease in venous return/decreased intravascular volume. So keep them well filled until the effusion can be drained. 

He went on to have 615 ml drained by cardiology.