PLE-2227

A 75-year-old male, who underwent left nephrectomy for renal cell carcinoma 6 months ago, is admitted to the emergency department with acute severe dyspnea and cyanosis. On physical examination, his blood pressure is 100/60, pulse rate is 120, respiratory rate is 25, and oxygen saturation is 75% while breathing room air. The oxygen saturation fails to rise under supplemental oxygen, even after intubation and mechanical ventilation with 100% oxygen. The arterial saturation further drops to 65% despite correct positioning of the tube. Chest X-ray shows clear lungs without infiltrates. Based on the patient’s diagnosis, what is a possible finding in the 2D echo?