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Cardiac tamponade — ACEM Fellowship MCQ

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HardCardiovascular emergenciesCardiac tamponadeACEM Fellowship

A 49-year-old man receiving haemodialysis presents to a Brisbane ED, triage category 1, with dyspnoea and presyncope. BP 82/58, HR 124, JVP is elevated and heart sounds are muffled. Bedside ultrasound shows a large pericardial effusion with right atrial collapse and a plethoric IVC. What is the most likely diagnosis?

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Correct answer: E — Cardiac tamponade

Hypotension, raised JVP, muffled heart sounds and echo evidence of right-sided chamber collapse indicate tamponade requiring urgent drainage planning.

Reference: ACEM FACEM Curriculum; ANZCOR ALS reversible causes