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- [22] A 50-Year-Old Woman Who Presents With Hypotension Cardiac tamponade. Cardiac tamponade is diagnosed when the clinical scenario fits, as was the case with the patient who presented with persistent shock without other cause, with the presence of a pericardial effusion, coupled with a dynamic finding such as diastolic collapse of the right ventricular free wall. Both a pericardial effusion and right ventricular free wall collapse can be seen on the parasternal long-axis view using the M-mode technique to delineate the timing of the right ventricular collapse. Absence of respiratory variation of the inferior vena cava by M-mode aids in the identification of obstructive shock physiology and is a finding with very high sensitivity in tamponade CHEST, 2018, 154 (01) : E9 - E12