Cardiac tamponade Quiz: Ace Your Exams

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A 67-year-old woman presents to the emergency department for evaluation of shortness of breath. The patient presented to her dialysis appointment today and was noted to be hypotensive, and she was subsequently referred to the emergency department. The patient's past medical history includes hypertension, diabetes, and end-stage renal disease. The patient appears short of breath. Temperature is 37°C (98.6°F), blood pressure is 95/71 mmHg, pulse is 110/min, respiratory rate is 22/min, and oxygen saturation is 97% on room air. Physical examination demonstrates jugular venous distension. The patient's chest x-ray is shown below. Which of the following additional examination findings is most likely to be present?

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Unilateral lower extremity swelling

Absent unilateral breath sounds

Muffled heart sounds

Regurgitant murmur

Diminished breath sounds over the lung bases