PMC4369869_01
Electrical alternans was clearly evidenced by the alternating amplitude of the QRS complexes (arrows).
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Fig1
Electrocardiography showed sinus tachycardia, low voltage and electrical alternans [Figure 1, Additional file 1].
Posteroanterior chest radiograph at presentation revealed a markedly enlarged cardiac silhouette and a left-sided pulmonary infiltrate.
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Fig2
The chest radiograph displayed an enlarged cardiac silhouette with a left-sided pulmonary infiltrate [Figure 2].
Two-dimensional transthoracic echocardiography visualized a large circumferential pericardial effusion (PE).
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Fig3
Transthoracic echocardiography confirmed features of cardiac tamponade from a large circumferential pericardial effusion, along with mobile intrapericardial fibrinous strands and the pleural effusion [Figures 3 and 4].
Two-dimensional transthoracic echocardiography was also remarkable for mobile fibrinous strands (arrows) between the visceral and parietal pericardium, as well as confirmation of a left-sided pleural effusion (PL).
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Fig4
Transthoracic echocardiography confirmed features of cardiac tamponade from a large circumferential pericardial effusion, along with mobile intrapericardial fibrinous strands and the pleural effusion [Figures 3 and 4].