Correct!
5. Repeat the beside echocardiogram

The renal ultrasound shown in figure 3 is normal. The normal renal size is about 4-5 in. or about 10-12 cm. The left kidney also appeared normal. The pulse tracing is not normal. It shows a marked drop with inspiration. A drop of > 10 mm Hg is abnormal and consistent with pulsus paradoxus. The repeat echocardiogram is shown in Figure 5.

Figure 5. Repeat beside ultrasound (4 chamber view).

Which of the following should be done next? (Click on the correct answer to proceed to the fifth and final panel)

  1. Continue anticoagulation for the atrial clot
  2. Needle pericardiocentesis
  3. Thoracentesis
  4. Thoracic surgery consult for pericardotomy
  5. Thoracic surgery consult to remove the migrated aortic valve

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