Question of the Week

For January 19, 2021

A 33-year-old woman is transferred to the cardiac intensive care unit for monitoring after successful percutaneous radiofrequency ablation of a supraventricular tachycardia. Her heart rate is 78 beats per minute, her blood pressure is 134/76 mm Hg, her respiratory rate is 12 breaths per minute, her oxygen saturation is 98% while breathing ambient air, and her central venous pressure is normal.

Shortly after transfer, she becomes acutely tachypneic and hypotensive, with a systolic blood pressure of 76 mm Hg. Her Korotkoff sounds are inaudible during inspiration. She has marked jugular venous distention and equal breath sounds without rales. Her femoral access site shows no evidence of a hematoma. Her electrocardiogram shows sinus tachycardia at 126 beats per minute. An intravenous bolus of normal saline is initiated.

Which one of the following diagnostic studies is most likely to show the cause of this patient’s clinical presentation?

Pulmonary CT angiography
Bedside echocardiography
Measurement of hemoglobin and hematocrit
Measurement of cardiac enzymes
Chest radiograph