Great job! This is a normal view of the heart from the subxiphoid view.
Here we have a subxiphoid view of the heart.
Remember that cardiac tamponade is a clinical diagnosis and cannot be made on ultrasound alone. However, an ultrasound scan can help us find an effusion which can help us make the diagnosis.
This scan is that of a normal heart. We don’t see any pericardial effusion. Indeed, we see the lucky 7 sign which represents the lateral wall of the ventricle and the interventricular septum. Afterwards, the heart is fanned through on both sides until it disappears, with no fluid showing up around the heart.
Therefore we can rule out pericardial effusion.
In this case, the patient’s symptoms are not concordant with that of an MI but they do seem to match that of a panic attack. Usually to treat a panic attack in the ER you want to focus on educating the patient on what it is and reassure them that it isn’t dangerous, that way they can learn to manage it on their own, without needing to rush to an ER every time they have a panic attack.