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A 45-year-old woman with a history of Hodgkin's lymphoma that had been treated with mantle-field irradiation 20 years earlier presented with pleuritic chest pain, progressive dyspnea, and presyncope. Notable findings on physical examination included tachycardia, a systolic blood pressure of 100 mm Hg with pulsus paradoxus (a 20 mm Hg decrease in systolic pressure on inspiration), an elevated jugular venous pressure (15 cm of water), and a three-component cardiac friction rub. The electrocardiogram showed sinus tachycardia and low voltage. An echocardiogram showed a small, circumferential pericardial effusion that could not be approached safely by pericardiocentesis. The patient subsequently underwent cardiac . . . [Full Text of this Article] |
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