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Massive cardiomegaly. Drainage due to known pericardial effusion. Bilateral opacities.
Cardiomegaly can be simply a result of supine AP projection (hints for AP supine: scapulae intrathoracic, missing gas bubble in fundus, stretched mediastinum). However, in this case the heart is massively enlarged. Pericardial effusion was echographically diagnosed. Note the pericardial drainage which seems to drain insufficiently. Patient is highly at risk for cardiac tamponade.