67 yo female with PMH of pericardial effusion (s/p subxiphoid pericardial window 9/18/2026), asthma/COPD, HTN, TR, CAD, HLD, and anemia presenting with 3 days of chest pressure that is worse lying flat and better sitting up, plus exertional dizziness. Vitals stable apart from mild tachycardia in the low 100s, comfortable on room air.
Bedside POCUS showed: