An 18-year-old female presented to the emergency department with a complaint of right-sided abdominal pain for one day. An abdominal computed tomography was significant for hepatic congestion and a large pericardial effusion. The patient was found to have early signs of cardiac tamponade on point-of-care ultrasonography. She was taken to the operating room for pericardial window and had immediate resolution of her symptoms. Patient was diagnosed with systemic lupus erythematosus based on laboratory and clinical findings. This case report details the atypical clinical features of our patient and highlights the subtle signs that should indicate the need for point-of-care cardiac ultrasonographic assessment in these patients.
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