Cardiac Arrest Due to Cardiac Tamponade

The patient with a history of lymphoma was seeking medical attention for a progressive shortness of breath and cough. He was started on oral antibiotics for presumed bronchitis. A chest XR was ordered (see image above).

The chest XR revealed cardiomegaly that was not present on a prior study. Shortly after, the patient came to the Emergency Room in cardiac arrest.

Emergent ECHO revealed a large pericardial effusion (labeled PF on the bottom image) with tamponade physiology and complete right ventricular collapse (labeled RV).

The patient required an emergent pericardiocentesis. The likely etiology – malignant pericardial effusion.