PMC4120057_01
Chest X-ray at supine position showing possible enlarged cardiac silhouette.
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F0001
A portable chest radiograph showed a right upper lobe infiltrate and a borderline enlarged cardiac silhouette, but it was noted by the radiologist that it could be artifactual given the antero-posterior projection of the chest radiograph (Fig. 1).
Electrocardiogram showing no tall QRS complex, but without meeting criteria for low QRS voltage.
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F0002
Specifically, electrical alternans was absent (Fig. 2).
2-D Echocardiogram showing the collapse of the right atrium at end diastole.
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F0003
The intensivist was consulted and performed a bedside ultrasound that revealed a pericardial effusion with diastolic collapse of the right atrium (Fig. 3) and right ventricle (Fig. 4).
Chest X-ray showing a smaller cardiac area after pericardiocentesis and pericardiotomy.
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F0005
Repeat chest radiograph showed a smaller cardiac silhouette (Fig. 5) and a repeat electrocardiogram showed slightly increase in voltage of QRS complexes (Fig. 6).