UNM CLINICAL CASE CONFERENCES Pericardial Effusion of Obscure Origin

A 41-year-old man was initially evaluated in the emer-gency department for a 2-month history of shortness of breath, abdominal distension, scrotal swelling, and left inguinal pain. Past history included long-term use of intravenous drugs, extensive and current alcohol use with evidence of cirrhosis based on laboratory findings, and imaging and seropositivity for hepatitis C antibody without measurable viremia. He also had a history of sustaining an upper abdominal stab wound requiring exploratory lapa-rotomy in the early 1990s. He denied fevers, rigors, night sweats, weight loss, or skin rashes. Initial evaluation revealed an ill appearing man with tachycardia (heart rate 120 beats/min) with mild hypoten-sion (blood pressure 85–105/50–60 mmHg), and tachypnea (respiratory rate 20–25/min) requiring 2 L/min supple