Shortness Of Breath in Medicine / Internal Medicine — 42yo Man | Cardiology | SMLE Q#6656
SMLE Question #6656
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: January 2026
A 42-year-old man presents to the emergency department with shortness of breath, fever, and fatigue for several days. Vital signs: T: 38.5 °C, BP: 90/60 mmHg, HR: 118/min, RR: 24/min, SpO2: 94% on room air. Physical examination reveals elevated jugular venous pressure, pulsus paradoxus, and distant heart sounds. An urgent bedside echocardiogram confirms a large pericardial effusion causing cardiac tamponade. Which cardiac layer is primarily involved in this condition?
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