Abstract

An 84-year-old woman presented to the emergency department with progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. She had a past history of atrial fibrillation and was taking digoxin. Clinical examination revealed normal vital signs, 6 cm of jugular venous distension with Kussmaul’s sign, a pericardial knock, and pedal edema.

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