Review Question - QID 213895

A 57-year-old man presents to the emergency department with chest pain. He states that it is worsened with exertion, deep breaths, and occurs at rest. He has a past medical history of obesity, diabetes, heart failure, hypertension, and peripheral vascular disease. He has a 30 pack-year smoking history. He recently traveled on a flight from China visiting his relatives and was exposed to his sick grandchildren. His temperature is 97.7°F (36.5°C), blood pressure is 174/94 mmHg, pulse is 88/min, respirations are 14/min, and oxygen saturation is 95% on room air. Physical exam is notable for a sweaty and uncomfortable man. He demonstrates normal heart sounds; however, the physician is unable to auscultate the patient’s cardiac apex in the left lateral decubitus position secondary to patient discomfort. An ECG is performed as seen in Figure A. Initial laboratory values including a troponin are pending. Which of the following findings would be seen on bedside echocardiography?