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Cardiac tamponade causing obstructive shock — RCPSC IM MCQ

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HardCritical CareCardiac tamponade causing obstructive shockRCPSC IM

A 49-year-old man with metastatic lung cancer develops acute dyspnea and hypotension. JVP is elevated, heart sounds are muffled and pulsus paradoxus is present. Bedside ultrasound shows a large pericardial effusion with right atrial collapse and plethoric IVC. Lactate is 4.8 mmol/L. What is the most appropriate management?

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Correct answer: C — Urgent pericardiocentesis

Obstructive shock with echocardiographic tamponade physiology requires urgent drainage of the pericardial space.

Reference: Canadian critical care and cardiology pericardial disease guidance