Cardiac Tamponade

CARDIAC TAMPONADE

A 46-year-old woman with systemic lupus erythe-matosus (SLE) and mild renal insufficiency presents with shortness of breath and orthopnea of 5 days’ duration. Her medications include tacrolimus, prednisone, and furosemide. On presentation to the emergency room, she has systemic hypotension, and distended neck veins which distend further upon inspiration. Transthoracic echocardiography reveals a large amount of pericardial fluid and echocardio-graphic signs of cardiac tamponade.