4 Days Of Dyspnea in Medicine / Internal Medicine — 42yo Man | Cardiology | SMLE Q#6656
SMLE Question #6656
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 42-year-old man presents to the emergency department with 4 days of dyspnea, fever, and fatigue. Examination shows elevated jugular venous pressure, pulsus paradoxus, and muffled heart sounds. Bedside echocardiography shows a large circumferential fluid collection surrounding the heart with right atrial diastolic collapse, consistent with cardiac tamponade. Which cardiac layer is primarily involved in this condition?
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