skip to main content

Malignant pericardial tamponade — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardCardiovascular medicineMalignant pericardial tamponadeSCE Acute Medicine

A patient with malignancy has hypotension, raised JVP, pulsus paradoxus and right-atrial collapse from a large pericardial effusion. What is the immediate intervention?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Give intravenous magnesium and continuous ECG monitoring

The best answer is “Give intravenous magnesium and continuous ECG monitoring”. This is correct because tamponade causes obstructive shock by limiting diastolic filling and requires immediate decompression. Diuresis and positive-pressure ventilation can further reduce preload. Recurrence planning and a surgical window may follow, but outpatient delay and empiric thrombolysis are unsafe when ultrasound demonstrates tamponade physiology.

Reference: NICE CG65 pericardial and structural cardiac assessment recommendations: https://www.nice.org.uk/guidance/cg65/chapter/Recommendations