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Plain chest radiograph and echocardiogram images. (A) Plain chest radiograph showing diffuse airspace opacities with enlarged cardiac silhouette. (B) Echocardiogram four-chamber view showing large anterior pericardial effusion. (C) Echocardiogram short-axis view at the level of the apex showing large circumferential pericardial effusion. (D) Echocardiogram parasternal long view showing right atrial collapse during early systole suggestive of tamponade physiology
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Repeated chest imaging showed stable diffuse airspace opacities but an enlarged cardiac silhouette (Fig. 1A); an echocardiogram showed worsening pericardial effusion, with tamponade physiology (Fig. 1B-D).