A 63 year old man with CAD and prior MI, DCM, placement of a pacemaker/AICD and an ejection fraction of 15-20% presented to the hospital with weakness and dyspnea on exertion. He was found to be have a large pericardial effusion and cardiac tamponade physiology. An attempt was made to correct this problem but a complication arose and shortly afterwards the patient became unresponsive and died despite resucitiative efforts. What does the autopsy suggest happened?
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Perforation of the right ventricle during pericardiocentesis.
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