15th May 2025

You are reviewing a patient on the cardiology ward who was admitted with a 1L pericardial effusion causing SOB.

You are reviewing a patient on the cardiology ward who was admitted with a 1L pericardial effusion  causing SOB. The patient has a background of metastatic lung cancer. You are called by the nurse who  is concerned about the patient’s NEWS score. The patient is hypotensive, tachypnoeic, and has a  reduced GCS. ECG shows alternating low-voltage and high-voltage QRS complexes.

Considering the most likely diagnosis, what would be the first line and definitive management of this  patient?

Select the SINGLE most appropriate option from the list below. Select ONE option  only.