27th July 2020

The following patient has presented with central chest pain which is worse on lying flat, and a diagnosis of pericardial effusion has been made

A 58-year-old patient with known chronic kidney disease secondary to type 2 diabetes mellitus and hypertension presents to the emergency department with chest pain. He reports feeling drowsy and not having urinated for the past 24 hours. His latest estimated glomerular filtration rate was calculated at 19ml/min/1.73m2. On examination he is confused, looks pale and his skin has a yellow tinge.  An echo shows the presence of a pericardial effusion. 

For the patient above, please select the SINGLE most likely cause of the pericardial effusion. Select ONE option from the list above.