Can you diagnose this mystery illness?
A 51-year-old woman reports a 1-year history of a chronic cough that produces a small amount of white sputum. Occasionally, the sputum is blood-streaked.
On physical examination, her temperature is 38.0°C (100.4°F). Pulse is 71 beats/min, respiratory rate is 19 breaths/min, and blood pressure is 125/80 mmHg.
Auscultation of the chest reveals crackles over the upper lung fields.
Heart sounds are faint, and there is a 15 mmHg decline in systolic arterial pressure on inspiration.
The chest radiograph shows prominent heart borders with a “water bottle” shape. Pericardiocentesis yields 200 mL of bloody fluid.