患儿男，4岁，高热7天，胸痛、咳嗽、呼吸困难2天。体检：呼吸急促，心界扩大，心音低钝、遥远，心前区闻及心包摩擦音，肝肋下4cm，质软缘钝，肝颈静脉回流征阳性，移动性浊音（+),双下肢永肿。此患儿最可能的临床诊断是

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