A 65-year-old male patient arrives to your Emergency department
following an episode of collapse shortly after an episode of
left-sided chest pain. He is anticoagulated with an INR of 2.4 for
atrial fibrillation. On arrival, he is hypotensive with a SBP of 70
mmHg, a lactate of 12 and a haemoglobin of 100 g/L.
A bedside ultrasound scan performed by the emergency physician
shows the following:
A CT scan with contrast is performed urgently after appropriate
What is the most likely diagnosis?