Abstract
A 48-year-old man with a history of alcohol and tobacco abuse presented to the emergency department with a 2-month history of progressive dyspnea. Physical examination revealed distention of the jugular vein and an enlarged left cervical lymph node. An anteroposterior chest radiograph showed cardiomegaly (Panel A). Computed tomographic imaging of the chest (Panel B) revealed a large pericardial effusion (asterisk), a lung mass in the left lower lobe, and necrotic-appearing left supraclavicular lymphadenopathy. Echocardiography confirmed the presence of a circumferential pericardial effusion (Panels C and D and video; asterisk). Diastolic collapse of the right ventricular (RV) free wall (Panel C, . . .
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