Correct!
4. 1 and 3

The most likely causes of her shortness of breath after a myectomy is fluid overload but this seems inconsistent with her fluid status. Pneumothorax is a consideration as is cardiac tamponade. Cardiac catherization is not indicated. Chest radiography (Figure 1) and bedside ultrasound were performed (Figure 2).

Figure 1. Portable chest radiograph.

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Figure 2. A: Static image from bedside ultrasound. Posterior chest, left side. B: Static image from bedside ultrasound. Left apical view. Lower left: video of bedside ultrasound posterior chest. Lower right: video of bedside ultrasound left apical view.

Her inferior vena cava was slightly enlarged at 1.9 cm (normal 1.2-1.7 cm).

What is the cause of the patient’s shortness of breath? (Click on the correct answer to proceed to the seventh and final page)

  1. Left atrial thrombus
  2. Pericardial effusion
  3. Pneumothorax
  4. 1 and 3
  5. All of the above

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