Changes

====Physical Exam====

====Physical Exam====

- Muffled heart sounds

* Muffled heart sounds

- Right-sided congestive heart failure: jugular venous distension, jugular pulses, ascites, pleural effusion

* Right-sided congestive heart failure: jugular venous distension, jugular pulses, ascites, pleural effusion

- Weak pulses due to poor cardiac output

* Weak pulses due to poor cardiac output

- Pulsus paradoxicus (pulse quality varies excessively with respiration)

* Pulsus paradoxicus (pulse quality varies excessively with respiration)

- Sinus tachycardia, compensatory mechanism for reduced cardiac output in order to maintain systemic blood pressure

* Sinus tachycardia, compensatory mechanism for reduced cardiac output in order to maintain systemic blood pressure

====Radiography====

====Radiography====