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121111 Radiology

A 41-year-old woman presents to the emergency depament with chest pain, shoness of breath, and worsening fatigue for the past day. The chest pain initially worsened with lying down and improved with leaning forward, but now it seems equal in intensity over all positions. On examination she has labored, fast breathing and appears to be in pain. She has jugular venous distention. She is tachycardic, and has distant hea sounds with a friction rub. Her lungs are clear to auscultation bilaterally, and she has no limb edema. Her pulse is 126/min, BP is 89/66 mm Hg, respiratory rate is 32/min, and oxygen saturation is 98% on room air. X-ray of the chest is shown below. Which of the following is the most likely diagnosis?

ACardiac tamponade
BAcute Pericarditis
CCongestive hea failure
DPanic attack
Radiology
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