Correct!
5. All of the above

The patient has a large pericardial effusion (Figure 2).

Figure 2. Panel A: Subxiphoid view from the echocardiogram with the pericardial effusion (PeriE), right atrium (RA) and inferior vena cava (IVC) labeled. Panel B: Slightly different subxiphoid view showing the pericardial effusion and a clot which might be confused with a valve.

Furthermore, there are signs of pericardial tamponade with the right-sided chambers collapsing during diastole. After stopping the anticoagulation and administering fresh frozen plasma, pericardiocentesis was performed (2). 550 ml of serosanguinous fluid was removed. There was immediate improvement in the blood pressure to 136/52 mm Hg. The patient had an eventful recovery and was discharged several days later.

References

1. Beaulieu Y. Bedside echocardiography in the assessment of the critically ill. Crit Care Med. 2007 May;35(5 Suppl):S235-49. [CrossRef] [PubMed] 
2. Tsang TS, Oh JK, Seward JB. Diagnosis and management of cardiac tamponade in the era of echocardiography. Clin Cardiol. 1999 Jul;22(7):446-52. [CrossRef] [PubMed]

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