Case of the Month #28 Cardiac Tamponade

Published 13/04/2022

What clinical signs may be present?

  • Pulsus paradoxus - a decrease of >10mmHg on inspiration is a marker of instability
  • Hypotension
  • Muffled heart sounds
  • Elevated JVP

Hypotension, muffled heart sounds and distended neck veins form the classical Beck’s triad. Patients may also complain of chest pain and/or shortness of breath. In the emergency setting they will likely be in extremis. Chronic causes will also present with associated symptoms such as a viral prodrome or autoimmune phenomenon [1].