13th March 2024

A 75-year-old male presents with chest pain and dyspnoea.

A 75-year-old male presents with chest pain and dyspnoea. He also reports weight loss of 8 kg in the past two months. His pain is exacerbated on lying supine and improves with sitting up and leaning forward. On examination his blood pressure is 95/50 mmHg, with muffled heart sounds and jugular venous distension. The patient denies subjective pyrexia and is afebrile at 36.4. An echocardiogram demonstrates a large immobile right-sided atrial lesion extending into the pericardium, with evidence of considerable pericardial effusion. 

Which one of the following options would be the most probable cause for this patient’s presentation? Select the SINGLE most appropriate option from the list below. Select ONE option only.