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A 45-year-old man presented to the Emergency Department with sudden onset of shortness of breath and was critically ill on arrival. He has had a motor vehicle accident 6 weeks prior with closed fracture of the right tibio-fibula and was treated conservatively with a cast. Subsequently, he arrested during intubation. He regained return of spontaneous circulation and was subsequently started on high- dose inotropes to sustain his blood pressure.
Bedside echocardiogram and ultrasound showed pathognomonic features of an important presentation in the Emergency Department.