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80-something year old with acute chest pain. 3 visits. Fascinating Ultrasound progression

Dr. Smith's ECG Blog

An 80-something year old man with history of metastatic cancer had acute onset of chest pain and called 911. Here was his cardiac echo (remember, done 9 hours after the one above): Pericardial Effusion with Tamponade physiology, developed within 9 hours. Here is his prehospital ECG: What do you think?