A patient was admitted to the ICU from the emergency department, where the patient came due to a rapid onset of dyspnea (approximately 2 hours), shivering and fever.
Patient´s history includes chronic ischemic heart disease, atrial fibrillation, ischemic cardiomyopathy with slightly reduced ejection fraction, intermittent 3rd degree AV block, pacemaker implantation, replacement of ascending aorta and aortic arch by aortic dissection type-A six years ago, moderate aortic regurgitation, chronic renal insufficiency, thoracotomy with resection of upper lobe of left lung with adjuvant chemotherapy three months ago and state after heparin-induced thrombocytopenia type (HIT) II.
Vital signs: GCS 15, blood pressure 140/80 mmHg, heart rate 82 bpm, SpO2 96 % with oxygen mask 8 l/min, temperature 39.2 °C.
Sonography was performed: