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Cardiac Tamponade — RACP Adult Medicine MCQ

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EasyCardiologyCardiac TamponadeRACP Adult Medicine

A 55-year-old man with known malignancy presents with dyspnoea, hypotension (BP 80/50), raised JVP with Kussmaul sign, muffled heart sounds, and pulsus paradoxus (20 mmHg). Echo shows a large pericardial effusion with RV diastolic collapse. What is the most appropriate immediate management?

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Correct answer: A — Pericardiocentesis

Beck triad (hypotension, raised JVP, muffled heart sounds) with pulsus paradoxus and echo confirming RV diastolic collapse is cardiac tamponade. Pericardiocentesis is the immediate life-saving intervention. IV fluid bolus may temporise while arranging drainage. Echo-guided pericardiocentesis is preferred. A pericardial drain should be left for ongoing drainage.

Reference: ESC – 2015 – Pericardial Disease Guidelines; eTG Cardiovascular 2024