by Michael Cenkowski, MD; Amer M. Johri, MD; Raveen Pal, MD; Jennifer Hutchison, RDCS –

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.