4 Days Of Fever in Medicine / Internal Medicine — 42yo Man | Cardiology | SMLE Q#1106

SMLE Question #1106

Medicine / Internal Medicine Cardiology
Last updated: February 2026
A 42-year-old man presents to the emergency department with 4 days of fever, fatigue, and progressive shortness of breath. He reports worse breathlessness when lying flat and chest discomfort. Examination shows elevated jugular venous pressure, muffled heart sounds, and a marked inspiratory fall in systolic blood pressure; there is no peripheral oedema. Which cardiac structure is primarily affected?

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