Focused cardiac ultrasound by the emergency physician has become a fundamental tool to expedite the diagnostic evaluation of the patient at bedside. We report the case of a patient admitted to the emergency department for respiratory distress. He was examined by an emergency physician who performed a bedside echocardiography. Bright spots were seen rapidly moving along the pericardial layer during diastole with comet-tail artifacts extending across the whole image of the heart and disappearing during systole, suggesting pneumopericardium.
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