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Pericardial tamponade — RCPSC IM MCQ

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ModerateCardiologyPericardial tamponadeRCPSC IM

A 49-year-old man with metastatic lung cancer presents with dyspnea and lightheadedness. Blood pressure is 84/56 mm Hg, JVP is elevated, heart sounds are muffled, and pulsus paradoxus is 18 mm Hg. Bedside ultrasound shows a large pericardial effusion with right atrial collapse. What is the most likely diagnosis?

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Correct answer: E — Cardiac tamponade

Hypotension, raised JVP, muffled heart sounds, pulsus paradoxus and echocardiographic chamber collapse indicate cardiac tamponade. Urgent pericardiocentesis is required when unstable.

Reference: Canadian Cardiovascular Society pericardial disease practice